DR. KENNETH GLENN RAWSON (NPI# 1295890366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295890366 |
| Entity Type | Individual |
| Full Name | DR. KENNETH GLENN RAWSON |
| Credential | DMD |
| Practice Address |
2800 College Ave Alton IL 62002-4742 |
| Practice Telephone | 6184747291 |
| Practice Fax Number | 6184747089 |
| Mailing Telephone | 6184747291 |
| Mailing Fax Number | 6184747089 |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2007-08-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
LL-072-05 | NV | Dental Providers |
| Street Address |
2800 COLLEGE AVE |
| City | ALTON |
| State | IL |
| Zip Code | 62002-4742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215912696 | Southern Illinois University Edwardsville School of Dental Medicine | Dentist | 2800 College Ave, Alton, IL 62002-4700 | 2005-12-08 |
| 1699382333 | Matthew Feigenbaum | Dentist | 2800 College Ave, Alton, IL 62002-4700 | 2020-09-27 |
| 1669088381 | Luke William Revelt | Dentist | 2800 College Ave, Alton, IL 62002-4742 | 2020-09-17 |
| 1013528801 | Teniola Omopariola | Dentist | 2800 College Ave, Alton, IL 62002-4742 | 2020-08-14 |
| 1285243170 | Michelle Hickey | Dentist | 2800 College Ave, Alton, IL 62002-4742 | 2020-07-27 |
| 1821607839 | Sogol H Biroon | Dentist | 2800 College Ave, Alton, IL 62002-4742 | 2020-07-26 |
| 1912530924 | Ioannis Gkikas | Dentist | 2800 College Ave, Alton, IL 62002-4742 | 2020-02-18 |
| 1942859509 | James Joseph Cahill | Dentist | 2800 College Ave, Alton, IL 62002-4700 | 2019-09-06 |
| 1023677218 | Lucas Winebaugh | Dentist | 2800 College Ave, Alton, IL 62002-4742 | 2019-06-11 |
| 1528552296 | Katherine Sue Hanser | Dentist | 2800 College Ave, Alton, IL 62002-4742 | 2018-06-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285272807 | Jersey Community Hospital | Obstetrics & Gynecology | #2 Memorial Drive, Suite 203, Alton, IL 62002 | 2019-12-13 |
| 1912540659 | Kelsi N Harre | Community Health Worker | 2603 N. Rogers Ave., Alton, IL 62002 | 2019-10-25 |
| 1841848322 | Destiny L Miller | Technician | 3429 Meridocia St, Alton, IL 62002 | 2019-08-28 |
| 1942854633 | Jessica Leigh Jump | Speech-Language Pathologist | 453 Bluff Street, Alton, IL 62002 | 2019-07-30 |
| 1194380741 | Vasiliki Kytridou | Dentist | 2800 College Avenue Southern Il University School of De, Building 285, Alton, IL 62002 | 2019-05-08 |
| 1982125910 | Amy Nicole Spalding | Social Worker | 1123 Harrison St, Alton, IL 62002 | 2017-06-29 |
| 1962856310 | Patricia Gregory | Social Worker | 5090 Humbert Rd, Alton, IL 62002 | 2016-04-21 |
| 1447612510 | Alanna Lynn Mcnelly | Chiropractor | 219 Piasa St, Suite 200, Alton, IL 62002 | 2016-03-28 |
| 1174983050 | Roberta's Lovely Ladies Boutique | Mastectomy Fitter | 603 W. Delmar, Alton, IL 62002 | 2016-03-04 |
| 1184081556 | Darcy Graham | Nurse Practitioner | 4 Memorial Dr # 210, Alton, IL 62002 | 2016-01-15 |
| Find all providers in zip 62002 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932709433 | Children's Center for Dentistry | Dentist | 314 Susan Dr, Normal, IL 61761-6206 | 2020-10-26 |
| 1073125746 | Jessica Mattern Dds, Pllc | Dentist | 326 W Burlington Ave, La Grange, IL 60525-2363 | 2020-08-23 |
| 1568925014 | Southern Illinois Pediatric Dentistry of Edwardsville | Dentist | 1419 Lewis Road, Suite 2, Edwardsville, IL 62025 | 2019-04-11 |
| 1710450754 | Drs Selberg & Rice Pllc | Dentist | 4945 Stone Falls Ctr Ste B, O Fallon, IL 62269-7801 | 2019-01-02 |
| 1821583634 | Dentalgenix | Dentist | 113 E Schaumburg Rd, Schaumburg, IL 60194-3518 | 2018-06-25 |
| 1528562253 | Rachel Vorwaller | Dentist | 1460 N Halsted St Ste 403, Chicago, IL 60642-2607 | 2018-03-19 |
| 1942740006 | Dhwani M. Joshi | Dentist | 195 S Rand Rd Ste 110, Lake Zurich, IL 60047-2205 | 2017-03-08 |
| 1316393390 | Erin Marie Petrik | Dentist | 2530 N Clark St, Apt 203, Chicago, IL 60614-4972 | 2016-05-10 |
| 1669839593 | Algonquin Kids Dentistry, Inc | Dentist | 4097 W Algonquin Rd, Algonquin, IL 60102-9401 | 2016-01-22 |
| 1720468598 | Mehedia Haque | Dentist | 2062 N Milwaukee Ave, Chicago, IL 60647 | 2015-06-05 |
| 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.