ORAL & MAXILLOFACIAL SURGEONS OF CENTRAL ILLINOIS
NPI 1275663338
Dentist in Peoria, IL
NPI Status: Active since March 07, 2007
Contact Information
5009 A EXECUTIVE DR
PEORIA, IL
ZIP 61614
Phone: (309) 693-1200
Fax: (309) 693-9998
Some details in this NPI profile have been updated in the NPI registry within the last 30 days.
- Organization
- Dentist
About ORAL & MAXILLOFACIAL SURGEONS OF CENTRAL ILLINOIS
This page provides the complete NPI Profile along with additional information for Oral & Maxillofacial Surgeons Of Central Illinois, a provider established in Peoria, Illinois operating as a Dentist. The healthcare provider is registered in the NPI registry with number 1275663338 assigned on March 2007. The practitioner's primary taxonomy code is 122300000X. The provider is registered as an organization and their NPI record was last updated September 2025. Oral & Maxillofacial Surgeons Of Central Illinois operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's
- NPI
- 1275663338
- Provider Legal Name
- ORAL & MAXILLOFACIAL SURGEONS OF CENTRAL ILLINOIS
- Other Organization Name
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 5009 A EXECUTIVE DR PEORIA, IL 61614
- Location Phone
- (309) 693-1200
- Location Fax
- (309) 693-9998
- Mailing Address
- 5009 A EXECUTIVE DRIVE PEORIA, IL 61614
- Mailing Phone
- (309) 693-1200
- Mailing Fax
- (309) 693-9998
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-07-2007
- Last Update Date
- 09-11-2025
- Code Navigator
A dentist like Oral & Maxillofacial Surgeons Of Central Illinois 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.
Location Map
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
- License State
- IL
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 1223S0112X | Dental Providers | Dentist | (IL) |
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.
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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. | |||||||||
| 1 | 2 | 7 | 5 | 6 | 6 | 3 | 3 | 3 | 8 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 14 | 5 | 12 | 6 | 6 | 3 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 1 + 4 + 5 + 1 + 2 + 6 + 6 + 3 + 6 + 24 = 62 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 62 = 8 | 8 | ||||||||
The NPI number 1275663338 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1275663338, enumerated in the NPI registry as an "organization" on March 07, 2007
The provider is located at 5009 A Executive Dr Peoria, Il 61614 and the phone number is (309) 693-1200
This medical organization specializes in Dentist with taxonomy code 122300000X
This NPI record was last updated on March 07, 2007. 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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