Burch Dental

Primary specialty

DentistTaxonomy code 122300000X

License

19026526 Issued in IL

Legal business name

BURCH DENTAL

Practice address

9721 N Alpine Rd
Machesney Park, IL 61115-1664

Phone

(815) 633-9864

NPI assigned

May 14, 2013

Last updated

Feb 3, 2025By 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

Melissa Kay Miller

Title

VP of Operations

Phone

(815) 631-2389

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1368489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738540800000",
    "number": "1811333156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 FOREST HILLS RD",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611112709",
            "telephone_number": "815-633-9864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9721 N ALPINE RD",
            "city": "MACHESNEY PARK",
            "state": "IL",
            "postal_code": "611151664",
            "telephone_number": "815-633-9864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8100 Forest Hills Rd",
            "address_purpose": "LOCATION",
            "city": "Loves Park",
            "state": "IL",
            "postal_code": "611112709",
            "country_code": "US",
            "telephone_number": "815-633-9864",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6078 Palo Verde Dr",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611148117",
            "country_code": "US",
            "telephone_number": "815-997-5904",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3914 N Main St",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611031673",
            "country_code": "US",
            "telephone_number": "815-968-2008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BURCH DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-14",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "815-631-2389"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "19026526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Machesney Park, IL
• Providers in Machesney Park, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; 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.