DR. JEFFREY BRIAN STOLLER (NPI# 1780880567) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780880567 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY BRIAN STOLLER |
| Credential | D.D.S. |
| Practice Address |
1608 Broadway St Pekin IL 61554-3806 |
| Practice Telephone | 3093464446 |
| Practice Fax Number | 3093532267 |
| Mailing Telephone | 3093464446 |
| Mailing Fax Number | 3093532267 |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | IL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366411043 | Jeffrey Bryan Stoller | Nurse Anesthetist, Certified Registered | 3601 W. 13 Mile Rd, 400 Fsc-pcs, Royal Oak, MI 48073-6769 | 2006-03-16 |
| Street Address |
1608 BROADWAY ST |
| City | PEKIN |
| State | IL |
| Zip Code | 61554-3806 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194279000 | Shauna L Bivens | Nurse Practitioner | 3400 Griffin Ave., Pekin, IL 61554 | 2016-08-09 |
| 1720349780 | Neal Family Chiropractic PC | Chiropractor | 2978 Court St., Pekin, IL 61554 | 2012-06-06 |
| 1366750671 | Dennis Kammerer Stoller | Dentist | 1608 Broadway, Pekin, IL 61554 | 2010-09-21 |
| 1013186683 | Tazwood Mental Health Center, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1421 Valle Vista Blvd, Pekin, IL 61554 | 2008-02-27 |
| 1568631133 | Tazwood Mental Health Center, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1425 Valle Vista Blvd, Pekin, IL 61554 | 2008-02-27 |
| 1689856312 | Pekin Supportive Living Limited Patnership | Assisted Living Facility | 1320 Executive Court, Pekin, IL 61554 | 2007-12-05 |
| 1205034824 | Winfield Curtis Morgan | Dentist | 1503 Valle Vista, Pekin, IL 61554 | 2007-07-05 |
| 1376769638 | Debra Mollie Davis | Registered Nurse | 2079 Edgewater Dr, Pekin, IL 61554 | 2007-04-17 |
| 1649308230 | Tazewell County Health Department -dental Health Center | Public Health or Welfare | 135 Radio City Drive, Suite A & B, North Pekin, IL 61554 | 2007-03-02 |
| 1528118239 | Jerry Lee Marshall | Dentist | 135a-b Radio City Drive, North Pekin, IL 61554 | 2007-01-12 |
| Find all providers in zip 61554 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205034824 | Winfield Curtis Morgan | Dentist | 1503 Valle Vista, Pekin, IL 61554 | 2007-07-05 |
| 1891827747 | Robert Joel Johnson | Dentist | 120 Park Ridge Ln, Pekin, IL 61554-3900 | 2007-03-09 |
| 1467515437 | Anthony John Demonte | Dentist | 3301 Griffin Avenue, Pekin, IL 61554-6237 | 2006-12-19 |
| 1144380882 | Kevin Conroy | Dentist | 13 Oh Ave, Pekin, IL 61554 | 2006-12-11 |
| 1972663607 | Stephen E Dickey | Dentist | 13 Olt Ave, Pekin, IL 61554 | 2006-12-11 |
| 1811079866 | Total Dental Care Ltd | Dentist | 13 Olt Avenue, Pekin, IL 61554 | 2006-10-19 |
| 1982056784 | Zuniga Dental, PC | Dentist | 1245 Florence Ave, Pekin, IL 61554-2325 | 2016-07-06 |
| 1962801738 | Adham Abdelrahim | Dentist | 3218 Court St, Pekin, IL 61554-6209 | 2014-08-18 |
| 1104110725 | Michael David Danner | Dentist | 1426 Valle Vista Blvd, Pekin, IL 61554-6224 | 2011-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124629076 | Align Dental Group PC. | Dentist | 2605 Grand Ave Ste A, Waukegan, IL 60085-2410 | 2020-11-06 |
| 1881293801 | Wh Il Dental Pllc | Dentist | 18086 N. Kilpatrick Ave., Chicago, IL 60639 | 2020-10-21 |
| 1982201505 | Ashley Rodriguez | Dentist | 2208 N Mannheim Rd, Melrose Park, IL 60164-1837 | 2020-10-06 |
| 1831796853 | Shaista Hasan | Dentist | 1840 Harvest Ln, Glendale Heights, IL 60139-1939 | 2020-10-02 |
| 1558978841 | William Mitsos Dds | Dentist | 1291 S. 7th Ave, Kankakee, IL 60901 | 2020-09-30 |
| 1477160190 | Smilesbysangha LLC | Dentist | 118 Barrington Commons Ct Ste 201, Barrington, IL 60010-3259 | 2020-09-27 |
| 1477160331 | Samer Mosoof | Dentist | 9 Monroe Ct, Streamwood, IL 60107-1365 | 2020-09-24 |
| 1881208478 | Poornima Swamy Gangaji | Dentist | 760 N, Illinois Rte 59, Ste100, Naperville, IL 60563 | 2020-09-01 |
| 1275145534 | Moondrift Sleep Solutions, LLC | Dentist | 837 N Wilke Rd, Arlington Heights, IL 60005-1047 | 2020-08-18 |
| 1023629664 | Mockunas Dental PC | Dentist | 13530 S Route 59 Unit 120, Plainfield, IL 60544-5659 | 2020-08-16 |
| 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.