MAPLE SHADE DENTAL (EAST PEORIA) LLC
NPI 1245522267
Dentist in East Peoria, IL

NPI Status: Active since May 10, 2011

Contact Information

1001 ILLINI DR
EAST PEORIA, IL
ZIP 61611
Phone: (309) 694-2620

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  • Organization
  • Dentist

About MAPLE SHADE DENTAL (EAST PEORIA) LLC

This page provides the complete NPI Profile along with additional information for Maple Shade Dental (east Peoria) Llc, a provider established in East Peoria, Illinois operating as a Dentist. The healthcare provider is registered in the NPI registry with number 1245522267 assigned on May 2011. The practitioner's primary taxonomy code is 122300000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. Maple Shade Dental (east Peoria) Llc operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Mike Cole (Insurance Director)

NPI
1245522267
Provider Name
MAPLE SHADE DENTAL (EAST PEORIA) LLC
Entity Type
Organization
Location Address
1001 ILLINI DR EAST PEORIA, IL 61611
Location Phone
(309) 694-2620
Mailing Address
6240 LAKE OSPREY DR DEPT 56057 LAKEWOOD RANCH, FL 34240
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-10-2011
Last Update Date
03-18-2024
Code Navigator

A dentist like Maple Shade Dental (east Peoria) Llc is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dentist

Taxonomy Code
122300000X
Type
Dental Providers
Taxonomy Description
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MIKE COLE

Authorized Official Title
INSURANCE DIRECTOR
Authorized Official Phone
(727) 726-1611

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1245522267
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
22851024212
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 8 + 5 + 1 + 0 + 2 + 4 + 2 + 1 + 2 + 24 = 53
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 53 = 77

The NPI number 1245522267 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 3 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1487921490 MICHAEL CONNOLLY
Individual
Dentist1001 ILLINI DR
EAST PEORIA, IL 61611
(309) 694-2620
1649764176 JIAYING REN DMD
Individual
Dentist (General Practice)1001 ILLINI DR
EAST PEORIA, IL 61611
(309) 222-8447
1154167203DR. MORGAN ELIZABETH BROCKHOUSE DMD
Individual
Dentist (General Practice)1001 ILLINI DR
EAST PEORIA, IL 61611
(309) 948-5524

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1245522267, enumerated in the NPI registry as an "organization" on May 10, 2011

The provider is located at 1001 Illini Dr East Peoria, Il 61611 and the phone number is (309) 694-2620

This medical organization specializes in Dentist with taxonomy code 122300000X

This NPI record was last updated on May 10, 2011. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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