Smalltown Dental Tremont

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SMALLTOWN DENTAL TREMONT

Practice address

140 Lake St
Tremont, IL 61568-8048

Phone

(309) 925-7851

NPI assigned

Apr 12, 2019

Last updated

Jun 29, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

SMALLTOWN DENTAL MANAGEMENT LLCAs reported in NPPES

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

Authorized official

Name

Luke Overcash

Title

Operations Manager

Phone

(309) 370-5853

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Katherine Anne Henderson, DMD

  • General Practice Dentistry
  • Morton, IL
  • NPI 1861045924
  NPD (past)
• Tyler Scott Flynn, DMD

  • Dentist
  • Palm Coast, FL
  • NPI 1205459153
  NPD (past)

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

{
    "created_epoch": "1555027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593388800000",
    "number": "1770046088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 LAKE ST",
            "city": "TREMONT",
            "state": "IL",
            "postal_code": "615688048",
            "telephone_number": "309-925-7851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 LAKE ST",
            "city": "TREMONT",
            "state": "IL",
            "postal_code": "615688048",
            "telephone_number": "309-925-7851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMALLTOWN DENTAL TREMONT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SMALLTOWN DENTAL MANAGEMENT LLC",
        "enumeration_date": "2019-04-12",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A",
        "authorized_official_last_name": "OVERCASH",
        "authorized_official_first_name": "LUKE",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "309-370-5853"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Owsley
• Ronald J Flanigan DDS,PC (Tremont Family Dental)
• S & W Pharmacies, Inc (Tremont Family Pharmacy)
• Tressa L Schneider, APN
• Teri L. Siedleck
• Tazewell County Resource Centers, Inc.
• Tazewell County Resource Centers, Inc.
• Tremont 702 Rescue Squad
• Tremont Community Unit School District # 702
• Tremont Medical Clinic SC

• Dental Clinic/Center in Tremont, IL
• Providers in Tremont, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; 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.