Innovation Dental and Implant LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

INNOVATION DENTAL AND IMPLANT LLC

Practice address

717 Insight Ave
O Fallon, IL 62269-2151

Phone

(618) 277-6550

NPI assigned

Jul 20, 2026

Last updated

Jul 20, 2026By 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

Diana Lifritz

Title

Director of Human Resources

Phone

(618) 873-7500

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1784505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784505600000",
    "number": "1932029907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1922 EDWARDSVILLE CLUB PLAZA CT",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253717",
            "telephone_number": "618-277-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 INSIGHT AVE",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692151",
            "telephone_number": "618-277-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATION DENTAL AND IMPLANT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-20",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-19",
        "status": "A",
        "authorized_official_last_name": "LIFRITZ",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "DIRECTOR OF HUMAN RESOURCES",
        "authorized_official_telephone_number": "618-873-7500"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in O'Fallon, IL
• Providers in O'Fallon, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2026; 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.