NPIMap

Organization Active NPI

Western Illinois Oral & Maxillofacial Surgery, LTD.

  • Oral and Maxillofacial Surgery (Dentist)
  • Galesburg, IL
National Provider Identifier
1932232287
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
WESTERN ILLINOIS ORAL & MAXILLOFACIAL SURGERY, LTD.
Practice address
929 W Carl Sandburg Dr
Galesburg, IL 61401-1342
Phone
(309) 344-3311
Fax
(309) 344-1052
NPI assigned
Mar 14, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Dan W. Kaspar, DDS MSNPI 1730168212
Title
President
Phone
(309) 344-3311

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X IL Primary

Addresses

Primary practice location

929 W Carl Sandburg Dr
Galesburg, IL 61401-1342

Mailing address

929 W Carl Sandburg Dr
Galesburg, IL 61401-1342
Phone (309) 344-3311

National Provider Directory

National Provider Directory

Locations

929 W Carl Sandburg Dr
Galesburg, IL 61401
Phone (309) 344-3311

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1932232287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 W CARL SANDBURG DR",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614011342",
            "telephone_number": "309-344-3311",
            "fax_number": "309-344-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 W CARL SANDBURG DR",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614011342",
            "telephone_number": "309-344-3311",
            "fax_number": "309-344-1052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN ILLINOIS ORAL & MAXILLOFACIAL SURGERY, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KASPAR",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-344-3311",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS MS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galesburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.