NPIMap

Organization Active NPI

Myotech, LLC

  • General Practice Dentistry
  • Moline, IL
National Provider Identifier
1811132467
Registry record updated May 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MYOTECH, LLC
Practice address
1828 Avenue of the Cities
Moline, IL 61265-4858
Phone
(309) 764-0008
Fax
(309) 764-0059
NPI assigned
Dec 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2015

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

Authorized official

Name
Dr. David A Jarrin, D.D.S.NPI 1710033840
Title
President
Phone
(309) 764-0008

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1828 Avenue of the Cities
Moline, IL 61265-4858

Mailing address

1828 Avenue of the Cities
Moline, IL 61265-4858
Phone (309) 764-0008

National Provider Directory

National Provider Directory

Locations

1631 Avenue of the Cities
Moline, IL 61265
Phone (309) 764-0008

Practitioners & affiliated clinicians

Practitioners 5

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": "1228953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432857600000",
    "number": "1811132467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1828 AVENUE OF THE CITIES",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612654858",
            "telephone_number": "309-764-0008",
            "fax_number": "309-764-0059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1828 AVENUE OF THE CITIES",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612654858",
            "telephone_number": "309-764-0008",
            "fax_number": "309-764-0059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYOTECH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-11",
        "last_updated": "2015-05-29",
        "status": "A",
        "authorized_official_last_name": "JARRIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-764-0008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moline, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2015; 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.