Pereira Dental, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PEREIRA DENTAL, PLLC

Practice address

740 W South St
Freeport, IL 61032-6840

Phone

(815) 599-1569

NPI assigned

Sep 15, 2026

Last updated

Sep 15, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marianne Tilton

Title

Provider Enrollment Supervisor

Phone

(315) 454-6000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1789430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789430400000",
    "number": "1770494007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70887",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441900887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 W SOUTH ST",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610326840",
            "telephone_number": "815-599-1569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEREIRA DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-15",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A",
        "authorized_official_last_name": "TILTON",
        "authorized_official_first_name": "MARIANNE",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT SUPERVISOR",
        "authorized_official_telephone_number": "315-454-6000"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kiley Pauls, OTR/L
• Pearl City Comm Unit Dist 200
• Pearl Pavilion LLC
• Rebecca Lynn Pedersen, MD
• Olivia Louise Pehl, D.C.
• Melina Mairoby Pereira Petit, DDS
• Michael R Perry, MD
• Mindy Sue Pettenger
• Trisha A Phillips, MS, CSADC, MISA I
• Kathleen Picci

• General Practice Dentistry in Freeport, IL
• Providers in Freeport, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; 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.