NPIMap

Organization Active NPI

David R Trost DDS PC

  • General Practice Dentistry
  • North Pekin, IL
National Provider Identifier
1750553327
Registry record updated Mar 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019016607 Issued in IL
Legal business name
DAVID R TROST DDS PC
Doing business as
Miles of Smiles, LTD
Practice address
137 Radio City Dr Ste F
North Pekin, IL 61554-1570
Phone
(309) 382-6404
Fax
(309) 382-6405
NPI assigned
Mar 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. David Ralph Trost, DDS
Title
President
Phone
(309) 382-6404

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 019016607 IL Primary

Addresses

Primary practice location

137 Radio City Dr Ste F
North Pekin, IL 61554-1570

Mailing address

137 Radio City Dr Ste F
North Pekin, IL 61554-1570
Phone (309) 382-6404

Other names 1

  • Miles of Smiles, LTD Doing business as

National Provider Directory

National Provider Directory
Tax ID family
David R Trost DDS PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

137 Radio City Dr
Ste F
North Pekin, IL 61554
Phone (309) 382-6404

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206316800000",
    "number": "1750553327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 RADIO CITY DR STE F",
            "city": "NORTH PEKIN",
            "state": "IL",
            "postal_code": "615541570",
            "telephone_number": "309-382-6404",
            "fax_number": "309-382-6405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 RADIO CITY DR STE F",
            "city": "NORTH PEKIN",
            "state": "IL",
            "postal_code": "615541570",
            "telephone_number": "309-382-6404",
            "fax_number": "309-382-6405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID R TROST DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-24",
        "last_updated": "2008-03-24",
        "status": "A",
        "authorized_official_last_name": "TROST",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "RALPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-382-6404",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019016607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Miles of Smiles, LTD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Pekin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.