LILLY FAMILY DENTISTRY, P.C. (NPI# 1770661951) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770661951 |
| Entity Type | Organization |
| Organization Name | LILLY FAMILY DENTISTRY, P.C. |
| Practice Address |
2100 Indian Hills Dr Sioux City IA 51104-1604 |
| Practice Telephone | 7122395125 |
| Practice Fax Number | 7122392275 |
| Mailing Telephone | 7122395125 |
| Mailing Fax Number | 7122392275 |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. KEVIN R. LILLY (OWNER) |
| Authorized Official Telephone | 7122395125 |
| 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 |
7577 | IA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 1106369 | 05 |
| Street Address |
2100 INDIAN HILLS DR |
| City | SIOUX CITY |
| State | IA |
| Zip Code | 51104-1604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598840704 | Kevin R. Lilly | Dentist | 2100 Indian Hills Dr, Sioux City, IA 51104-1604 | 2006-10-26 |
| 1891176723 | Phuong Cam Nguyen | Dentist | 2100 Indian Hills Dr, Sioux City, IA 51104-1604 | 2015-06-16 |
| 1790166940 | Aaron Fuehrer | Dentist | 2100 Indian Hills Dr, Sioux City, IA 51104-1604 | 2015-06-13 |
| 1538244744 | Jane M. Lilly | Dentist | 2100 Indian Hills Dr, Sioux City, IA 51104-1604 | 2006-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578944435 | Family First Dental Associates of Iowa, P.C. | Dentist | 2100 Indian Hills Drive, Sioux City, IA 51104 | 2015-06-16 |
| 1740590785 | Khatu Vivienne Erlbacher | Pharmacist | 515 North Briar Path, Sioux City, IA 51104 | 2010-10-08 |
| 1730407545 | Randall Glen Wood | Emergency Medicine | 2720 Stone Park Blvd., Sioux City, IA 51104 | 2010-05-04 |
| 1790811024 | Fred R Rizk | Dentist | 1923 Nebraska Street, Siuox City, IA 51104 | 2007-02-23 |
| 1255474029 | Edilia Maria Marshall | Dentist | Summit Dental, 2114 Pierce St, Sioux City, IA 51104 | 2007-02-14 |
| 1063553410 | Thomas Leonard Tiedeman | Dentist | 2918 Hamilton Blvd, Upper D Suite 1, Sioux City, IA 51104 | 2007-02-09 |
| 1336209188 | Shawn Robert Walton | Dentist | 2410 Pierce Street, Sioux City, IA 51104 | 2006-12-11 |
| 1477649556 | Timothy R Kuntz | Dentist | 3012 Hamilton Blvd, Sioux City, IA 51104 | 2006-10-05 |
| 1528162732 | Duane Kent Nelson | Orthopaedic Surgery | 2800 Peirce St, Suite 101, Sioux City, IA 51104 | 2006-09-08 |
| 1659482206 | Shawn R Walton | Dentist | 2928 Hamilton Blvd, Suite 102, Sioux City, IA 51104 | 2006-08-31 |
| Find all providers in zip 51104 | ||||
| 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 |
|---|---|---|---|---|
| 1578944435 | Family First Dental Associates of Iowa, P.C. | Dentist | 2100 Indian Hills Drive, Sioux City, IA 51104 | 2015-06-16 |
| 1346630654 | Iowa Dental Health Professionals, P.C. | Dentist | 5738 Sunnybrook Dr, Sioux City, IA 51106-4249 | 2015-01-26 |
| 1821386616 | Jennifer Lynae Smith | Dentist | 5708 Sunnybrook Dr., Sioux City, IA 51106 | 2011-07-14 |
| 1740592831 | Karla J Thole-bechtold | Dentist | 5845 Sunnybrook Dr, Sioux City, IA 51106-4203 | 2010-07-06 |
| 1093034365 | Charles H. Kiple D.d.s., P.C. | Dentist | 4704 Morningside Ave, Sioux City, IA 51106-3020 | 2010-05-25 |
| 1801054259 | Shamayne M. Frank, Dds, PC | Dentist | 321 W. 25th St., Sioux City, IA 51104-4029 | 2008-05-31 |
| 1033322508 | Brian Bradley Bursick | Dentist | 4100 Morningside Avenue, Suite B, Sioux City, IA 51106 | 2007-05-08 |
| 1053432047 | Richard F Hettinger | Dentist | 3900 Floyd Blvd, Sioux City, IA 51108-1552 | 2007-04-03 |
| 1730215351 | Douglas Alan Wheelock | Dentist | 4100 Morningside Ave, Suite B, Sioux City, IA 51106-2974 | 2007-02-26 |
| 1710012422 | James William Mcallister | Dentist | 4801 Southern Hills Dr, Sioux City, IA 51106-4747 | 2007-02-22 |
| Find all providers in SIOUX CITY | ||||
| City | SIOUX CITY |
| Zip Code | 51104 |
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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.