ROCKRIVER DENTAL LLC (NPI# 1336477769) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336477769 |
| Entity Type | Organization |
| Organization Name | ROCKRIVER DENTAL LLC |
| Practice Address |
318 College Ave Rockford IL 61104-2922 |
| Practice Telephone | 8159655555 |
| Practice Fax Number | 8159655561 |
| Mailing Telephone | 8159655555 |
| Mailing Fax Number | 8159655561 |
| Enumeration Date | 2009-11-23 |
| Last Update Date | 2009-11-23 |
| Authorized Official Name | DR. DUANE HANSEN (SOLE MEMBER) |
| Authorized Official Telephone | 8159655555 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
019019603 | IL | Dental Providers |
| Street Address |
318 COLLEGE AVE |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61104-2922 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003982257 | Wei Gao | Dentist | 318 College Ave, Rockford, IL 61104-2922 | 2006-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699216564 | Swedishamerican Hospital | Nutritionist | 1415 E. State St., Lower Level A3, Rockford, IL 61104 | 2017-03-13 |
| 1376950485 | Swedishamerican Hospital | Nurse Practitioner | 1340 Charles St Ste 200, Rockford, IL 61104 | 2014-07-21 |
| 1871907774 | Oday Alsarraf | Psychiatry & Neurology | 1401 E State Street, Center for Mental Health, Swedish American Hospital, Rockford, IL 61104 | 2014-06-18 |
| 1962652339 | Children's Home and Aid | Community/Behavioral Health | 424 7th St, Rockford, IL 61104 | 2008-09-23 |
| 1689729535 | Swedishamerican Hospital | Nurse Practitioner | 1340 Charles St Ste 100, Rockford, IL 61104 | 2007-01-23 |
| 1790873016 | David J Schleicher | Obstetrics & Gynecology | 209 9th St Ste 200, Rockford, IL 61104 | 2006-10-11 |
| 1013026624 | Thomas Ryan Moss | Dentist | 1415 E State Street, Rockford, IL 61104 | 2006-08-29 |
| 1366452096 | Arturo Santiago Manas | Obstetrics & Gynecology | 1415 E State St Fl 8, Rockford, IL 61104 | 2006-08-08 |
| 1245263268 | William John Stout | Physician Assistant | 1401 E State Street, Rockford, IL 61104 | 2006-07-10 |
| 1689604969 | Prabha Chand Dosi | Pediatrics | 1401 E. State Street, Rockford, IL 61104 | 2006-07-03 |
| Find all providers in zip 61104 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386252344 | Kacie Crowell Green | Dentist | 8900 Walnut St # 459, Rockford, MN 55373-5135 | 2020-07-16 |
| 1730547936 | Perryville Dentist PC | Dentist | 845 S Perryville Rd, Unit 119, Rockford, IL 61108 | 2016-02-02 |
| 1295192144 | Woolery Dental P.C. | Dentist | 5301 E State St Ste 306, Rockford, IL 61108-2390 | 2016-01-23 |
| 1467849679 | Christopher Lee Greenwaldt | Dentist | 845 S Perryville Rd Unit 127, Rockford, IL 61108-4340 | 2015-04-26 |
| 1427463785 | Yong Woo Lee | Dentist | 7310 Walton St, Rockford, IL 61108-4614 | 2014-06-25 |
| 1750624110 | Austriaco Dental Associates LLC | Dentist | 7310 Walton St Ste A, Rockford, IL 61108-4614 | 2013-04-03 |
| 1609173749 | Kathryn Ashley Edgcomb | Dentist | 1376 Reid Farm Rd, Rockford, IL 61107-2679 | 2011-02-25 |
| 1629393962 | Affordable Dentistry Today | Dentist | 5819 E Riverside Blvd # 21, Rockford, IL 61114-4963 | 2010-03-30 |
| 1346563525 | Modern Dental of Rockford LLC | Dentist | 1321 Sandy Hollow Rd, Rockford, IL 61109-2120 | 2010-03-02 |
| 1063667079 | Wilson Dental, PC | Dentist | 610 E. Division, Rockford, MI 49341 | 2008-11-19 |
| Find all providers in ROCKFORD | ||||
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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.