FORFAR DENTAL PARTNERS, PC EDP OF ILLINOIS (NPI# 1154712784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154712784 |
| Entity Type | Organization |
| Organization Name | FORFAR DENTAL PARTNERS, PC EDP OF ILLINOIS |
| Other Organization Name | AFFORDABLE DENTAL OF ILLNOIS |
| Practice Address |
195 S Main St Dupo IL 62239-1347 |
| Mailing Address |
141 W Jackson Blvd Ste 210 Chicago IL 60604-3048 |
| Practice Telephone | 3128001270 |
| Mailing Telephone | 3128001270 |
| Enumeration Date | 2015-02-18 |
| Last Update Date | 2020-11-02 |
| Authorized Official Name | MELISSA GARIBAY (CREDENTIALING MANAGER) |
| Authorized Official Telephone | 3127368963 |
| Is Organization Subpart | Y |
| Parent Organization Name | FORFAR DENTAL PARTNERS, PC EDP OF ILLINOIS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
021.001656 | IL | Dental Providers |
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Affordable Dental of Illnois | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 195 S Main St, Dupo, IL 622391347 | 6182864400 | 6182864407 |
| Street Address |
195 S MAIN ST |
| City | DUPO |
| State | IL |
| Zip Code | 62239-1347 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487968814 | Affordable Dentistry of Il LLC | Dentist | 195 S Main St, Dupo, IL 62239-1347 | 2010-07-27 |
| 1972773281 | John Norman Kimmich | Dentist | 195 S Main St, Dupo, IL 62239-1347 | 2008-03-04 |
| 1063552453 | Affordable Dental of Illinois | Clinic/Center | 195 S Main St, Dupo, IL 62239-1347 | 2007-02-07 |
| 1477693091 | Lloyd George Forester Jr. | Dentist | 195 S Main St, Dupo, IL 62239-1347 | 2007-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184180051 | Courtney Barlow | Nurse Practitioner | 1329 N 2nd St, Dupo, IL 62239-1049 | 2019-02-15 |
| 1598210056 | Michael Robert Dambacher | Physical Therapy Assistant | 95 Stoney Dr, Dupo, IL 62239-1160 | 2016-08-24 |
| 1770667172 | Dupo Fire Protection District | Ambulance | 501 Columbia Road, Dupo, IL 62239-1301 | 2006-10-24 |
| 1528681764 | Holon Inclusive Behavioral Health | Psychiatry & Neurology | 301 S Main St, Dupo, IL 62239-1325 | 2020-05-21 |
| 1417570920 | Jessica Whelan LLC | Registered Nurse | 301 S Main St, Dupo, IL 62239-1325 | 2020-05-19 |
| 1437462637 | Pc Associates, LLC | Family Medicine | 325 S Main St, Dupo, IL 62239-1325 | 2010-07-16 |
| 1700893989 | Ken Kloess | Dentist | 240 S Main St, Dupo, IL 62239-1357 | 2006-08-01 |
| 1932256112 | Michael Z Bialas | Chiropractor | 1421 Columbia Rd, Dupo, IL 62239-1429 | 2007-01-03 |
| 1679774632 | Community Unit School District No 196 | Local Education Agency (LEA) | 600 Louisa Ave, Dupo, IL 62239-1469 | 2007-05-29 |
| 1275149734 | Kristen Kay White | Psychologist | 600 Louisa Ave, Dupo, IL 62239-1469 | 2020-09-21 |
| Find all providers in zip 62239 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063552453 | Affordable Dental of Illinois | Clinic/Center | 195 S Main St, Dupo, IL 62239-1347 | 2007-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124629514 | Chicago Pediatric Dentistry and Orthodontics | Clinic/Center | 1136 S Delano Ct W Ste B202, Chicago, IL 60605-3734 | 2020-11-03 |
| 1437750031 | Secure Dental Xi | Clinic/Center | 1843 W Golf Rd, Schaumburg, IL 60194-1148 | 2020-11-02 |
| 1780283267 | Jenna Gaw, Dds, Pllc | Clinic/Center | 1724 Locust Pl Apt 303, Schaumburg, IL 60173-4239 | 2020-10-26 |
| 1740889344 | Nsp Dental LLC | Clinic/Center | 1900 Hollister Dr Ste 190, Libertyville, IL 60048-5283 | 2020-10-23 |
| 1285232827 | Paul Doodes Dds Phd PC | Clinic/Center | 45 S Park Blvd Ste 190, Glen Ellyn, IL 60137-6282 | 2020-10-15 |
| 1780290676 | Great Smile Dental Pllc | Clinic/Center | 720 Osterman Ave Ste 304, Deerfield, IL 60015-4339 | 2020-09-16 |
| 1669087375 | Naperville Smiles Dental | Clinic/Center | 8 W Gartner Rd Ste 124, Naperville, IL 60540-7549 | 2020-09-09 |
| 1649883364 | Mark J Maly Estate | Clinic/Center | 103 S Main St # Po, Orangeville, IL 61060-9244 | 2020-08-24 |
| 1760094718 | Stoffel and Tomazin Dental Associates, Ltd | Clinic/Center | 5718 W 35th St, Cicero, IL 60804-4222 | 2020-08-20 |
| 1215548771 | Meda Dental II LLC | Clinic/Center | 2735 Hassert Blvd Ste 159, Naperville, IL 60564-5205 | 2020-08-10 |
| Find all providers with the same taxonomy | ||||
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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.