FREEPORT DENTAL (NPI# 1891165643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891165643 |
| Entity Type | Organization |
| Organization Name | FREEPORT DENTAL |
| Practice Address |
1450 S West Ave Freeport IL 61032-6351 |
| Practice Telephone | 8156564060 |
| Practice Fax Number | 8156562324 |
| Mailing Telephone | 8156564060 |
| Mailing Fax Number | 8156562324 |
| Enumeration Date | 2015-10-05 |
| Last Update Date | 2015-10-05 |
| Authorized Official Name | SCOTT BARES (OWNER) |
| Authorized Official Telephone | 8156564060 |
| Is Organization Subpart | Y |
| Parent Organization Name | SHADYOAK DENTAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
019027024 | IL | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GENERAL DENISTRY | 1164580734 | 01 |
| Street Address |
1450 S WEST AVE |
| City | FREEPORT |
| State | IL |
| Zip Code | 61032-6351 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013402841 | Naramsin Ashoormaram | Dentist | 1450 S West Ave, Freeport, IL 61032-6351 | 2018-06-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013517713 | Saad Awan | Pharmacist | 2545 Illinois 26 S, Freeport, IL 61032 | 2020-10-30 |
| 1891354460 | Freeport Chiropractic LLC | Chiropractor | 2 W Stephenson St, Freeport, IL 61032 | 2019-06-07 |
| 1487168373 | Lindsey Rae Harris-baker | Speech-Language Pathologist | 1802 W Laurel St, Freeport, IL 61032 | 2017-11-30 |
| 1861871246 | Pearl Pavilion LLC | Skilled Nursing Facility | 910 Kiwanis Drive, Freeport, IL 61032 | 2015-05-19 |
| 1245584598 | Mary E Brown | Massage Therapist | 815 W. Pleasant Street, Freeport, IL 61032 | 2012-11-07 |
| 1700135803 | April Braband | Specialist | 421 Exchange, Freeport, IL 61032 | 2012-09-05 |
| 1518198662 | Quad City Prosthetic Inc | Prosthetic/Orthotic Supplier | 1013 W Loras Dr, Suite A, Freeport, IL 61032 | 2009-08-06 |
| 1447486501 | Gary Alan Besley | Dentist | 1450 S. West Ave., Freeport, IL 61032 | 2009-06-03 |
| 1023244290 | Allies In Health Sc | Chiropractor | 418 W Meadows Dr., Freeport, IL 61032 | 2009-06-02 |
| 1912146614 | Kayla Nicole Rodebaugh | Specialist/Technologist | 1010 Fairway Drive, Freeport, IL 61032 | 2009-02-19 |
| Find all providers in zip 61032 | ||||
| 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 |
|---|---|---|---|---|
| 1417247529 | Lindsay L Shirley | Dentist | 30 Blueberry Road, Freeport, FL 32439 | 2011-04-10 |
| 1588962971 | Long Island Family Dentistry | Dentist | 26 W Merrick Rd, Freeport, NY 11520-3827 | 2011-03-08 |
| 1447486501 | Gary Alan Besley | Dentist | 1450 S. West Ave., Freeport, IL 61032 | 2009-06-03 |
| 1801060876 | Jose' Antonio Lazo | Dentist | 186 Atlantic Ave, Freeport, NY 11520-4923 | 2008-04-21 |
| 1447422456 | Freeport Dental, PC | Dentist | 117 W Sunrise Hwy, Freeport, NY 11520-3614 | 2008-03-31 |
| 1902081185 | Lorraine Ann Herrmann | Dentist | 268 W Merrick Rd, Freeport, NY 11520-3347 | 2008-01-07 |
| 1558573329 | Crispin Zapanta Ayroso | Dentist | 131 S Ocean Ave, Suite 5 & 6, Freeport, NY 11520-4548 | 2007-05-04 |
| 1730307240 | Jonathan Goold Strout | Dentist | 46 Mallett Dr, Freeport, ME 04032-1313 | 2007-04-22 |
| 1740305614 | Joseph H Wetherhold | Dentist | 348 Us Route 1, Freeport, ME 04032-7016 | 2007-03-20 |
| 1427184993 | John Francis Masters | Dentist | 140 South Long Beach Avenue, Freeport, NY 11520-4336 | 2007-02-26 |
| Find all providers in FREEPORT | ||||
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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.