Active NPI
Janet Christine Bardell, D.M.D.
- Dentist
- Bloomington, IL
National Provider Identifier
1891041331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019.029071
- Practice address
- 2111 E Oakland Ave
Ste. D
Bloomington, IL 61701-5758 - Phone
- (309) 663-6564
- NPI assigned
- Aug 2, 2012
- Last updated
- Aug 13, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019.029071 | IL | Primary |
Addresses
Primary practice location
2111 E Oakland Ave
Ste. D
Bloomington, IL 61701-5758
Mailing address
2111 E Oakland Ave
Ste. D
Bloomington, IL 61701-5758
Phone (309) 663-6564
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.029071 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Solo Dental Group PLLC | Dentist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439424000000",
"number": "1891041331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2111 E OAKLAND AVE",
"address_2": "STE. D",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617015758",
"telephone_number": "309-663-6564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2111 E OAKLAND AVE",
"address_2": "STE. D",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617015758",
"telephone_number": "309-663-6564"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARDELL",
"first_name": "JANET",
"middle_name": "CHRISTINE",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-02",
"last_updated": "2015-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019.029071",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.