NPIMap

Organization Active NPI

Galva Family Dentistry, Inc

  • Dentist
  • West Peoria, IL
National Provider Identifier
1851836795
Registry record updated Jul 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019030989 Issued in IL
Legal business name
GALVA FAMILY DENTISTRY, INC
Practice address
2024 W Rohmann Ave
West Peoria, IL 61604-5500
Phone
(309) 692-5863
Fax
(309) 692-3618
NPI assigned
Jan 2, 2017
Organization subpart
Yes
Parent organization
GALVA FAMILY DENTISTRY, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 7, 2020

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

Authorized official

Name
Scott Bialobreski, D.D.S.
Title
President
Phone
(309) 932-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 019030989 IL Primary

Addresses

Primary practice location

2024 W Rohmann Ave
West Peoria, IL 61604-5500

Mailing address

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

Other names 1

  • River City 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.

Locations

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

6926 N University St
Peoria, IL 61614

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": "1483315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594080000000",
    "number": "1851836795",
    "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": "2024 W ROHMANN AVE",
            "city": "WEST PEORIA",
            "state": "IL",
            "postal_code": "616045500",
            "telephone_number": "309-692-5863",
            "fax_number": "309-692-3618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALVA FAMILY DENTISTRY, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GALVA FAMILY DENTISTRY, INC",
        "enumeration_date": "2017-01-02",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A",
        "authorized_official_last_name": "BIALOBRESKI",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-932-2000",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019030989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "River City Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "River City Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2020; 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.