Organization Active NPI

Tanya L Desanto, DDS

Doing business as Prairie Dental Group

  • Dentist
  • Springfield, IL
National Provider Identifier
1801517743
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
TANYA L DESANTO, DDS
Doing business as
Prairie Dental Group
Practice address
2900 Greenbriar Dr
Springfield, IL 62704-6418
Phone
(217) 546-0412
Fax
(217) 546-0919
NPI assigned
Sep 8, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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

Authorized official

Name
Mrs. Robin Hayes
Title
Office Manager
Phone
(217) 546-0412

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

2900 Greenbriar Dr
Springfield, IL 62704-6418

Mailing address

2900 Greenbriar Dr
Springfield, IL 62704-6418
Phone (217) 546-0412

Other names 1

  • Prairie Dental Group Doing business as

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

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": "1662595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664841600000",
    "number": "1801517743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 GREENBRIAR DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627046418",
            "telephone_number": "217-546-0412",
            "fax_number": "217-546-0919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 GREENBRIAR DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627046418",
            "telephone_number": "217-546-0412",
            "fax_number": "217-546-0919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TANYA L DESANTO, DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-08",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "217-546-0412",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prairie Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.