DR. JOSEPH LONG (NPI# 1447602370) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447602370 |
| Entity Type | Individual |
| Full Name | DR. JOSEPH LONG |
| Credential | D.D.S. |
| Practice Address |
611 W Park St Urbana IL 61801-2529 |
| Practice Telephone | 2173261297 |
| Enumeration Date | 2016-07-03 |
| Last Update Date | 2016-07-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
018.001998 | IL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619407939 | Joseph Maxwell Long | Specialist/Technologist | 117 Russell Rd Apt 201, Cayce, SC 29033-1983 | 2017-06-19 |
| 1285728170 | Joseph Michael Long | Psychologist | 1113 E 5th, Washington, MO 63090 | 2006-10-03 |
| 1629085931 | Joseph G Long | Chiropractor | 506 Hospital Dr, Mountain Home, AR 72653-2913 | 2006-08-01 |
| 1982104592 | Joseph Long | Behavior Technician | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2018-02-20 |
| 1760922322 | Joseph Long II | Nurse Practitioner | 210 Village Center Blvd Ste 200, Myrtle Beach, SC 29579-6706 | 2017-03-02 |
| 1477759116 | Joseph L Long | Dentist | 21 Northbrook Dr, Falmouth, ME 04105-1346 | 2007-06-21 |
| 1225116379 | Joseph E. Long | Internal Medicine | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2006-11-02 |
| 1801978911 | Joseph Michael Long | Family Medicine | 7000 Jefferson St Ne, Albuquerque, NM 87109-4313 | 2006-10-19 |
| 1578679197 | Joseph Blake Long | Pediatrics | 4750 Waters Ave, Suite 512, Savannah, GA 31404-6200 | 2006-08-23 |
| 1871528828 | Joseph Merl Long | Family Medicine | 2805 N Navarro St, Suite #320, Victoria, TX 77901-3946 | 2006-07-11 |
| Street Address |
611 W PARK ST |
| City | URBANA |
| State | IL |
| Zip Code | 61801-2529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831193416 | Mark L Saxton | Surgery | 611 W Park St, Urbana, IL 61801-2529 | 2005-06-10 |
| 1083214514 | Karissa Nelson | Physical Therapist | 611 W Park St, Urbana, IL 61801-2529 | 2020-10-26 |
| 1720698756 | Justin Matthew Felix | Surgery | 611 W Park St, Urbana, IL 61801-2529 | 2020-08-04 |
| 1033729306 | Patricia Fairchild | Occupational Therapist | 611 W Park St, Urbana, IL 61801-2529 | 2020-08-03 |
| 1851909782 | Shruti Agarwal | Internal Medicine | 611 W Park St, Urbana, IL 61801-2529 | 2020-07-16 |
| 1396363321 | Muhammad Umair Rana | Internal Medicine | 611 W Park St, Urbana, IL 61801 | 2020-07-07 |
| 1740807817 | Salma Malik | Internal Medicine | 611 W Park St, Urbana, IL 61801 | 2020-07-06 |
| 1477171536 | Audrey T Lam | Internal Medicine | 611 W Park St, Urbana, IL 61801-2529 | 2020-07-06 |
| 1255959318 | Corbin Reid Mah | Surgery | 611 W Park St, Urbana, IL 61801-2529 | 2020-07-06 |
| 1093332652 | Knika Sethi | Surgery | 611 W Park St, Urbana, IL 61801-2529 | 2020-06-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417566084 | Avani Sushilkumar Mohta | Internal Medicine | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2020-07-29 |
| 1922617133 | Recovery Concepts Urbana, LLC | Clinic/Center | 710 W. Killarney St., Urbana, IL 61801 | 2020-07-24 |
| 1447877089 | Muhammad Khalid Abbas | Internal Medicine | 611 W Park St Urbana, Urbana, IL 61801 | 2020-06-30 |
| 1003430166 | Conlan Joseph Pierce | Surgery | 601 W Park St, Urbana, IL 61801 | 2020-06-04 |
| 1568090900 | Luke Andrew Fenlon | Student in an Organized Health Care Education/Training Program | Carle Forum Lower Level, Mc-474, 611 West Park Street, Urbana, IL 61801 | 2020-03-31 |
| 1912559691 | Ali Baltaji | Internal Medicine | 101 N Busey Apt 7, Urbana, IL 61801 | 2019-07-12 |
| 1821510918 | Pallavi Pradeep | Internal Medicine | Imrp, Carle Foundation Hospital, 611 W Park Street, Urbana, IL 61801 | 2017-07-11 |
| 1093236002 | Angela Lynn Devaney | Speech-Language Pathologist | 1400 W Park, Presence Covenant Medical Center, Urbana, IL 61801 | 2017-06-29 |
| 1346775236 | Jennifer Garcia | Student in an Organized Health Care Education/Training Program | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2017-04-27 |
| 1467992537 | Amber Kristine Davis | Speech-Language Pathologist | 1400 W. Park, Presence Health Medical Center, Urbana, IL 61801 | 2017-03-08 |
| Find all providers in zip 61801 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356837322 | Mitchell Ryan Mascaro | Dentist | 611 W Park St, Urbana, IL 61801-2529 | 2018-07-02 |
| 1619407608 | Brian Mitchell | Dentist | 611 W Park St, Urbana, IL 61801-2529 | 2017-06-13 |
| 1245783307 | Baxter William Jones | Dentist | 611 W Park St, Urbana, IL 61801-2529 | 2016-07-25 |
| 1760738272 | Minseok Kang | Dentist | 611 W Park St, Urbana, IL 61801-2500 | 2012-08-02 |
| 1720314537 | Craig S Norbutt | Dentist | 611 W Park St, Urbana, IL 61801-2500 | 2009-10-29 |
| 1013176098 | Daniel Simmonds Cannon | Dentist | 611 W Park St, Urbana, IL 61801 | 2008-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255986576 | Othman Rezki | Dentist | 1900 W Polk St # 611, Chicago, IL 60612-3723 | 2019-08-04 |
| 1215410584 | David Peterson | Dentist | 1619 Brandywine Ln, Dixon, IL 61021-8757 | 2018-09-12 |
| 1952887374 | Winnebago Braces, LLC. | Dentist | 555 N Court St Ste 110, Rockford, IL 61103-6898 | 2018-07-18 |
| 1093232951 | Robert C. Bosack, Dds & Associates, Ltd | Dentist | 16011 108th Ave Ste A, Orland Park, IL 60467-8787 | 2017-08-23 |
| 1790146132 | Family Millennium Dentistry, Inc. | Dentist | 1342 W Randolph St, Chicago, IL 60607-1522 | 2016-03-13 |
| 1770962375 | Eunsu Jung | Dentist | 1902 N Prospect Ave Ste 1, Champaign, IL 61822-1411 | 2015-05-28 |
| 1811374945 | Alexandria Hawkins | Dentist | 6050 Brynwood Dr Ste 102, Rockford, IL 61114-6579 | 2015-04-27 |
| 1043607872 | Alissa Nicole Pullos | Dentist | 105 E 1st St Ste 103, Hinsdale, IL 60521 | 2015-04-20 |
| 1538592654 | Matthew Seena Hamedani | Dentist | 3116 Oak Park Ave, Berwyn, IL 60402 | 2013-08-13 |
| 1578907689 | M Timothy Murphy | Dentist | 500 Davis St Ste 509, Evanston, IL 60201-4621 | 2013-04-18 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. JOSEPH LONG.
| 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.