Secure Dental II

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019028807 Issued in IL

Legal business name

SECURE DENTAL II

Practice address

4601 16TH St
Unit 12
Moline, IL 61265-7000

Phone

(815) 708-2762

NPI assigned

Mar 27, 2013

Last updated

Mar 27, 2013By 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

Dr. Nazish Hasan Jafri, DDSNPI 1538447321

Title

Dentist

Phone

(815) 708-2762

Specialties & licenses 1

Addresses

Tax ID family

Secure Dental Davenport2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Secure Dental II, LLC

  dba Secure Dental Davenport

  • Dentist
  • Davenport, IA
  • NPI 1902258379
  NPD tax ID

Locations

Practitioners 1

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.

• Nazish Hasan Jafri, D.D.S.

  • Dentist
  • Peoria, IL
  • NPI 1538447321
  Authorized official Same address or phone

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364342400000",
    "number": "1992048912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1695 DIVINE DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075417",
            "telephone_number": "815-708-2762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 16TH ST",
            "address_2": "UNIT 12",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612657000",
            "telephone_number": "815-708-2762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECURE DENTAL II",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-27",
        "last_updated": "2013-03-27",
        "status": "A",
        "authorized_official_last_name": "JAFRI",
        "authorized_official_first_name": "NAZISH",
        "authorized_official_middle_name": "HASAN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "815-708-2762",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019028807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Schuttloffel
• Mary Evelyn Schwenn, ARNP
• Virginia Ann Schwieder, DC
• James M Scranton, D.C.
• Morgen Scroggins, D.C
• Secure Dental VI (Secure Dental Rock Island)
• Philip J Sepanski, LCPC
• David Victor Shaffer, D.C.
• Leslie Anne Shaffer, PHARMD
• Dipak S. Shah, M.D.

• General Practice Dentistry in Moline, IL
• Providers in Moline, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; 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.