LIFETIME DENTAL CARE OF ILLINOIS, PC (NPI# 1831311158) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831311158 |
| Entity Type | Organization |
| Organization Name | LIFETIME DENTAL CARE OF ILLINOIS, PC |
| Other Organization Name | SOUTHWOODS CENTRE DENTAL CARE |
| Practice Address |
240 Southwoods Centre Drive Columbia IL 62236 |
| Practice Telephone | 6182819888 |
| Practice Fax Number | 6182819889 |
| Mailing Telephone | 6182819888 |
| Mailing Fax Number | 6182819889 |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2008-05-21 |
| Authorized Official Name | AMY KROEGER (INS COOD) |
| Authorized Official Telephone | 2175405100 |
| Is Organization Subpart | Y |
| Parent Organization Name | LIFETIME DENTAL CARE OF ILLINOIS, PC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Southwoods Centre Dental Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487867750 | Lifetime Dental Care of Illinois, PC | Dentist | 1366 E Main, Carbondale, IL 62901 | 2007-05-07 |
| 1689887952 | Lifetime Dental Care of Illinois, PC | Dentist | 2633 Chatham Road, Suite A, Springfield, IL 62704 | 2007-05-07 |
| 1700099066 | Lifetime Dental Care of Illinois, PC | Dentist | 2943 W White Oaks Drive, Springfield, IL 62704 | 2007-05-07 |
| 1659583656 | Lifetime Dental Care of Illinois, PC | Dentist | 700 N Keller, Effingham, IL 62401 | 2007-05-04 |
| 1720290638 | Lifetime Dental Care of Illinois, PC | Dentist | 411 Keokuk Street, Lincoln, IL 62656 | 2007-05-04 |
| 1487866919 | Lifetime Dental Care of Illinois, PC | Dentist | 7310 N. Villa Lake Drive, Suite B, Peoria, IL 61614 | 2007-05-04 |
| 1023230281 | Lifetime Dental Care of Illinois, PC | Dentist | 1001 E Main, Carbondale, IL 62901 | 2007-05-03 |
| 1376765776 | Lifetime Dental Care of Illinois, PC | Dentist | 703b S Neil, Champaign, IL 61820 | 2007-05-03 |
| 1396967741 | Lifetime Dental Care of Illinois, PC | Dentist | 1200 W Jackson, Macomb, IL 61455 | 2007-05-03 |
| 1801018270 | Lifetime Dental Care of Illinois, PC | Dentist | 907 W Marketview, Unit 11, Champaign, IL 61822 | 2007-05-03 |
| Street Address |
240 SOUTHWOODS CENTRE DRIVE |
| City | COLUMBIA |
| State | IL |
| Zip Code | 62236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962937300 | Assoicated Physicians Group Ltd | Nurse Practitioner | 1011 South, Suite 3b, Columbia, IL 62236 | 2017-04-24 |
| 1316284854 | Robert Siekerka | Pharmacist | 1412 N Evergreen Ln, Columbia, IL 62236 | 2013-01-03 |
| 1972874352 | Jennifer Harlin Wilhelm | Veterinarian | 1400 Columbia Center Drive, Bellson Animal Hospital, Columbia, IL 62236 | 2012-01-18 |
| 1912275314 | Synergy Therapeutics, PC | Dentist | 1000 Eleven South, Suite 3f, Columbia, IL 62236 | 2011-12-13 |
| 1134455991 | Julie Williams | Skilled Nursing Facility | 3 Eagle Crest Court, Columbia, IL 62236 | 2009-10-28 |
| 1730301268 | Affordable Dentistry Today, PC | Dentist | 242 Southwoods Centre Drive, Columbia, IL 62236 | 2007-05-03 |
| 1710109616 | Jason Clay King | Chiropractor | 117 West Cedar Street, Columbia, IL 62236 | 2007-05-02 |
| 1184704900 | Mitan Pediatric Therapy Inc | Occupational Therapist | 891 Meadowview Lane, Columbia, IL 62236 | 2006-10-16 |
| 1265528368 | Kathryn Ann Mager | Counselor | 9273 Coach Stop Road, Columbia, IL 62236 | 2006-10-05 |
| 1144320086 | Family Medicine In Columbia | Family Medicine | 123 Wedgewood Dr, Columbia, IL 62236 | 2006-09-22 |
| Find all providers in zip 62236 | ||||
| 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 |
|---|---|---|---|---|
| 1184239832 | Adam Wesley Gadbois | Dentist | 220 Diego Dr, Columbia, MO 65203-4919 | 2020-09-10 |
| 1841803855 | Craig Thomas Luskey | Dentist | 4500 Stuart St Fl 3, Columbia, SC 29207-5700 | 2020-08-28 |
| 1710505169 | Dentists of Devine, PC | Dentist | 4600 Devine St Ste B, Columbia, SC 29205-3617 | 2020-07-13 |
| 1134745227 | Kayla White | Dentist | 1401 Forum Blvd Ste 203, Columbia, MO 65203-1915 | 2020-06-24 |
| 1962033001 | Ivy Creek Family Dentistry LLC | Dentist | 9007 Two Notch Rd Ste B, Columbia, SC 29223-5834 | 2020-01-28 |
| 1538701230 | Sulekha Agrawal Dmd LLC | Dentist | 9194 Red Branch Rd Ste A, Columbia, MD 21045-2005 | 2019-10-14 |
| 1619522794 | Timothy Drew Edwards | Dentist | 122 N. Brickyard Rd, Columbia, SC 29223 | 2019-08-06 |
| 1245885284 | Mana Shoeybi | Dentist | 6955 Oakland Mills Rd Ste 0, Columbia, MD 21045-5849 | 2019-08-06 |
| 1528628716 | Soh of Missouri Samson Liu PC | Dentist | 303 N Keene St # 202-210, Columbia, MO 65201-8050 | 2019-06-19 |
| 1417511783 | Molly Kayleen Pincelli | Dentist | Ph Usc Medical Group Dentistry, 10 Medical Park, Columbia, SC 29203 | 2019-04-23 |
| Find all providers in COLUMBIA | ||||
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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.