PRAIRIE CIRCLE DENTAL, P.C. (NPI# 1912036385) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912036385 |
| Entity Type | Organization |
| Organization Name | PRAIRIE CIRCLE DENTAL, P.C. |
| Other Organization Name | DR. RICHARD D. DAVIDSON |
| Practice Address |
703 N Niles Ave Tuscola IL 61953-1059 |
| Practice Telephone | 2172535216 |
| Practice Fax Number | 2172534949 |
| Mailing Telephone | 2172535216 |
| Mailing Fax Number | 2172534949 |
| Enumeration Date | 2007-03-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. RICHARD D. DAVIDSON (OWNER) |
| Authorized Official Telephone | 2172535216 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | IL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Dr. Richard D. Davidson | Former Legal Business Name - Organization |
| Street Address |
703 N NILES AVE |
| City | TUSCOLA |
| State | IL |
| Zip Code | 61953-1059 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952462749 | Richard D Davidson | Dentist | 703 N Niles Ave, Tuscola, IL 61953-1059 | 2006-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336545581 | Paul H. Byron | Hearing Instrument Specialist | 602 E. Southline Road, Audibel Hearing Aids, Tuscola, IL 61953 | 2014-11-17 |
| 1679851232 | Beth Ann Wiessing | Speech-Language Pathologist | 1601 East County Road 850 North, Tuscola, IL 61953 | 2011-08-01 |
| 1538356480 | Bart M Tate | Physical Therapist | 301 East Southline Rd, Tuscola, IL 61953 | 2007-09-25 |
| 1972724979 | Kimberly B Whitaker | Family Medicine | 1100 Tuscola Blvd, Sbl Tuscola Clinic, Tuscola, IL 61953 | 2007-05-01 |
| 1396856688 | Tuscola Pain & Wellness Center Sc | Chiropractor | 902 S Court Suite 2, Tuscola, IL 61953 | 2006-08-31 |
| 1225089626 | Nathan L Roberts | Family Medicine | 301 E. Southline Road, Tuscola, IL 61953 | 2006-05-12 |
| 1326008137 | Jamison T Boyd | Optometrist | 902 S Court St, Suite #1, Tuscola, IL 61953 | 2006-03-24 |
| 1629405907 | Ashley K Tennill | Nurse Practitioner | 1100 Tuscola Blvd, Sbl Tuscola Walk In Clinic, Tuscola, IL 61953 | 2013-10-02 |
| 1487892865 | Swarnalatha Jaliparthi | Family Medicine | 301 E. Southline Road, Tuscola, IL 61953 | 2009-01-23 |
| 1295834901 | Sally J Salmons | Family Medicine | 301 E. Southline Road, Tuscola, IL 61953 | 2006-09-21 |
| Find all providers in zip 61953 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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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.