NPIMap

Organization Active NPI

Galva Family Dentistry, Inc

  • General Practice Dentistry
  • Peoria, IL
National Provider Identifier
1831606433
Registry record updated Jan 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019016453 Issued in IL
Legal business name
GALVA FAMILY DENTISTRY, INC
Practice address
114 W Stratford Dr
Peoria, IL 61614-7301
Phone
(309) 682-6459
Fax
(309) 682-7036
NPI assigned
Jan 4, 2018
Organization subpart
Yes
Parent organization
GALVA FAMILY DENTISTRY, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 4, 2018

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

Authorized official

Name
Pamela Bates
Title
General Manager
Phone
(309) 932-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 019016453 IL Primary

Addresses

Primary practice location

114 W Stratford Dr
Peoria, IL 61614-7301

Mailing address

217 Market St
Galva, IL 61434-1766
Phone (309) 932-2000

Other names 1

  • The Knolls Family Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Galva Family Dentistry Inc7 organizations share this tax ID, including this one
Part of
Galva Family Dentistry Inc

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

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": "1515024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515024000000",
    "number": "1831606433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 MARKET ST",
            "city": "GALVA",
            "state": "IL",
            "postal_code": "614341766",
            "telephone_number": "309-932-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 W STRATFORD DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616147301",
            "telephone_number": "309-682-6459",
            "fax_number": "309-682-7036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALVA FAMILY DENTISTRY, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GALVA FAMILY DENTISTRY, INC",
        "enumeration_date": "2018-01-04",
        "last_updated": "2018-01-04",
        "status": "A",
        "authorized_official_last_name": "BATES",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "309-932-2000"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019016453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Knolls Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2018; 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.