NPIMap

Organization Active NPI

Quad City Orthodontic Group, LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Rock Island, IL
National Provider Identifier
1790872117
Registry record updated Apr 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
QUAD CITY ORTHODONTIC GROUP, LLC
Practice address
2850 24TH St
Rock Island, IL 61201-5308
Phone
(309) 786-7782
Fax
(309) 786-5829
NPI assigned
Oct 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2008

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

Authorized official

Name
Dr. Anne Bronwen Richards, D.D.S., M.S.NPI 1194904292
Title
Member/Doctor
Phone
(309) 786-7782

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X IL Primary

Addresses

Primary practice location

2850 24TH St
Rock Island, IL 61201-5308

Mailing address

2850 24TH St
Rock Island, IL 61201-5308
Phone (309) 786-7782

Other names 1

  • Quad City Orthodontics Doing business as

National Provider Directory

National Provider Directory

Locations

2850 24th St
Rock Island, IL 61201
Phone (309) 486-7782

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207267200000",
    "number": "1790872117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 24TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015308",
            "telephone_number": "309-786-7782",
            "fax_number": "309-786-5829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 24TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015308",
            "telephone_number": "309-786-7782",
            "fax_number": "309-786-5829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUAD CITY ORTHODONTIC GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2008-04-04",
        "status": "A",
        "authorized_official_last_name": "RICHARDS",
        "authorized_official_first_name": "ANNE",
        "authorized_official_middle_name": "BRONWEN",
        "authorized_official_title_or_position": "MEMBER/DOCTOR",
        "authorized_official_telephone_number": "309-786-7782",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.S."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quad City Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rock Island, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.