NPIMap

Organization Active NPI

Applewhite Dental Illinois, P.C.

  • General Practice Dentistry
  • Dixon, IL
National Provider Identifier
1972157154
Registry record updated Jul 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
APPLEWHITE DENTAL ILLINOIS, P.C.
Practice address
654 Reynoldswood Rd
Dixon, IL 61021-9108
Phone
(815) 288-4028
Fax
(815) 622-4028
NPI assigned
Jul 26, 2019
Organization subpart
Yes
Parent organization
APPLEWHITE DENTAL ILLINOIS, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 29, 2019

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

Authorized official

Name
Sharon L Loso
Title
Credentialing Specialist
Phone
(563) 582-1448

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

654 Reynoldswood Rd
Dixon, IL 61021-9108

Mailing address

40 Main St Ste 100
Dubuque, IA 52001-7654
Phone (563) 582-1448

Other names 1

  • Sauk Valley Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Applewhite Dental Illinois PC5 organizations share this tax ID, including this one
Part of
Applewhite Dental Illinois PC

Other organizations with this tax ID 4

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

Locations

654 Reynoldswood Rd
Dixon, IL 61021
Phone (815) 288-4028

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 3

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": "1564099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564358400000",
    "number": "1972157154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 MAIN ST STE 100",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520017654",
            "telephone_number": "563-582-1448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 REYNOLDSWOOD RD",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610219108",
            "telephone_number": "815-288-4028",
            "fax_number": "815-622-4028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPLEWHITE DENTAL ILLINOIS, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "APPLEWHITE DENTAL ILLINOIS, P.C.",
        "enumeration_date": "2019-07-26",
        "last_updated": "2019-07-29",
        "status": "A",
        "authorized_official_last_name": "LOSO",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "563-582-1448"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sauk Valley Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sauk Valley Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dixon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2019; 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.