SHADI RADY KHILLAH (NPI# 1124433396) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124433396 |
| Entity Type | Individual |
| Full Name | SHADI RADY KHILLAH |
| Credential | DDS |
| Practice Address |
357 E Michigan Ave Galesburg MI 49053-9763 |
| Practice Telephone | 2696659997 |
| Practice Fax Number | 2696655088 |
| Mailing Telephone | 2696659997 |
| Mailing Fax Number | 2696655088 |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2017-04-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 2901021326 | MI | Dental Providers |
| Street Address |
357 E MICHIGAN AVE |
| City | GALESBURG |
| State | MI |
| Zip Code | 49053-9763 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912351446 | Galesburg Dental Care | Clinic/Center | 357 E Michigan Ave, Galesburg, MI 49053-9763 | 2016-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497240162 | Ella Philander | Assistant Behavior Analyst | 5370 N 37th St, Galesburg, MI 49053 | 2018-06-26 |
| 1992098404 | Terry Ray Walker | Pharmacist | 9880 E. Michigan Ave, Galesburg, MI 49053 | 2011-05-17 |
| 1144746637 | Richard Alvin Finedell Jr. | Nurse Practitioner | 10310 Miller Dr, Galesburg, MI 49053 | 2017-08-17 |
| 1801900121 | Judy J Mitchelson | Physician Assistant | 10310 Miller Dr, Galesburg, MI 49053 | 2006-08-17 |
| 1306071634 | Amy Kay Embury | Psychologist | 9673 Candytuft, Galesburg, MI 49053-7724 | 2009-05-15 |
| 1134579378 | Nicole Tijerina | Technician, Other | 8396 Doe Ave, Galesburg, MI 49053-7742 | 2016-06-19 |
| 1700038684 | James C Breneman | Allergy & Immunology | 10571 Miller Dr, Galesburg, MI 49053-8607 | 2008-10-22 |
| 1467098202 | Nicole Marie Conway | Nurse Practitioner | 9880 E Michigan Ave # 100, Galesburg, MI 49053-8641 | 2019-11-26 |
| 1790892305 | Leon B Papendick | Physician Assistant | 9880 E Michigan Ave, Suite 100, Galesburg, MI 49053-8641 | 2006-08-23 |
| 1467673525 | The Doctors Group | Family Medicine | 9880 E Michigan Ave, Suite 100, Galesburg, MI 49053-8641 | 2007-05-02 |
| Find all providers in zip 49053 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| 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. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619311248 | Illinois Institute of Dental Sleep Medicine Inc | Dentist | 261 N Broad St, Galesburg, IL 61401-4563 | 2013-04-25 |
| 1144588153 | Akash P Patel | Dentist | 3074 Whitehaven Cir, Galesburg, IL 61401-8688 | 2012-04-27 |
| 1306066535 | Arnold John Minor | Dentist | 69 N Chambers St, Galesburg, IL 61401 | 2007-04-30 |
| 1114032794 | John Robert Bicego Jr. | Dentist | 1172 Monroe St, Galesburg, IL 61401 | 2006-08-21 |
| 1659385086 | Kandy Sue Sayrs | Dentist | 1865 N Henderson St Ste 9, Galesburg, IL 61401-1377 | 2006-07-29 |
| 1821087214 | William Todd Bollaert | Dentist | 209 E Main St, Galesburg, IL 61401-4716 | 2005-10-18 |
| 1447819180 | Helen Y Kim | Dentist | 2506 Volunteer Dr, Galesburg, IL 61401-8654 | 2019-06-06 |
| 1568941763 | Evelyn Margaret Nord-england | Dentist | 1237 Sweetbriar Pl, Galesburg, IL 61401-2343 | 2018-08-08 |
| 1689183816 | Erin Jain | Dentist | 1171 N Henderson St, Galesburg, IL 61401-2523 | 2017-09-20 |
| 1578923744 | Charles A Fifield Jr. | Dentist | 209 E Main St, Galesburg, IL 61401-4716 | 2016-03-02 |
| Find all providers in GALESBURG | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.