DR. ROBERT OWEN WOLF (NPI# 1962576967) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1962576967 |
Entity Type | Individual |
Full Name | DR. ROBERT OWEN WOLF |
Credential | DDS |
Practice Address |
107 S Prospect Rd Bloomington IL 61704-4403 |
Mailing Address |
700 N Larrabee St #115 Chicago IL 60654-7014 |
Practice Telephone | 3096630433 |
Mailing Telephone | 2169730552 |
Enumeration Date | 2006-11-20 |
Last Update Date | 2015-01-26 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 122300000X | Dentist | 019.028496 | IL | Dental Providers |
N | 1223G0001X |
Dentist Specialization: General Practice |
30-019566 | OH | Dental Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972988566 | Robert Wolf | Marriage & Family Therapist | 2100 Monument Blvd Ste 17, Pleasant Hill, CA 94523-3400 | 2015-07-23 |
1609058478 | Robert Auer Wolf | Family Medicine | 181 La Vereda Rd, Pasadena, CA 91105-1225 | 2007-12-03 |
1821136136 | Robert Allen Wolf | Family Medicine | 9179 E Happy Hollow Dr, Scottsdale, AZ 85262-2574 | 2007-02-01 |
1750432308 | Robert Wolf | Optometrist | 206 N Madison St, Woodstock, IL 60098-3450 | 2007-01-12 |
1063597581 | Robert Irwin Wolf | Psychologist | 529 W 42nd St, Apt. 2l, New York, NY 10036-6220 | 2006-10-25 |
1841206729 | Robert Hugh Wolf | Chiropractor | 2960 St Rose Parkway #150, Henderson, NV 89052 | 2006-07-31 |
1376566034 | Robert John Wolf | Internal Medicine | 240 Saunders Rd, Riverwoods, IL 60015-3835 | 2006-07-25 |
1598722936 | Robert Wolf | Psychiatry & Neurology | 1073 Oak St Se, Salem, OR 97301-4018 | 2006-04-28 |
1003805904 | Robert J Wolf | Radiology | 1540 Lake Lansing Rd, Suite 107, Lansing, MI 48912-3756 | 2005-10-14 |
1215925235 | Robert Jordan Wolf | Family Medicine | 361 Fair Hill Dr, Elkton, MD 21921-2512 | 2005-10-13 |
Street Address |
107 S PROSPECT RD |
City | BLOOMINGTON |
State | IL |
Zip Code | 61704-4403 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033602883 | Brock Gardner | Dentist | 107 S Prospect Rd, Bloomington, IL 61704-4403 | 2018-06-06 |
1366795437 | Maple Shade Dental Bloomington LLC | Dentist | 107 S Prospect Rd, Bloomington, IL 61704-4403 | 2012-10-26 |
1851670152 | Clint Boyle | Dentist | 107 S Prospect Rd, Bloomington, IL 61704-4403 | 2011-08-04 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518430859 | Visionpoint Eye Center LLC | Optometrist | 1107 Airport Road, Bloomington, IL 61704 | 2019-01-09 |
1922588235 | Geethu Sabu Makil | Speech-Language Pathologist | 1039 Blueheron Way, Apt#3, Bloomington, IL 61704 | 2018-08-16 |
1629596812 | Mental Wellness Center Inc | Counselor | 202 N Prospect Rd Ste 207, Bloomington, IL 61704 | 2017-09-07 |
1649798513 | Sarah Goodner | Psychologist | 1704 Royal Pointe Drive, Bloomington, IL 61704 | 2017-08-31 |
1346760253 | Elizabeth Devlin | Nurse Practitioner | 25 Long Cove Ct, Bloomington, IL 61704 | 2017-06-21 |
1396107918 | Darla Schwertfeger | Specialist/Technologist, Other | 2104 Hedgewood Dr, Bloomington, IL 61704 | 2016-03-23 |
1740662949 | Oncology Hematology Associates of Central Illinois | Pharmacy | 3105 Magory Drive, Bloomington, IL 61704 | 2015-06-24 |
1821478967 | Kelly R Andrews | Massage Therapist | 4101 Wicker Rd, Bloomington, IL 61704 | 2015-06-03 |
1235522582 | All Ways Caring Services, Inc. | In Home Supportive Care | 209 S Prospect Rd, Suite 3e, Bloomington, IL 61704 | 2015-03-11 |
1396093977 | Bhawna Gupta | Physical Therapist | 2200 East Washington Street, Bloomington, IL 61704 | 2012-08-29 |
Find all providers in zip 61704 |
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 |
---|---|---|---|---|
1962026948 | Maria Contreras Mantilla | Dentist | 1320 W Bloomfield Rd, Bloomington, IN 47403-2001 | 2020-06-04 |
1144703026 | Aneetam Bassi | Dentist | 3609 General Electric Rd Ste A, Bloomington, IL 61704-8766 | 2018-09-07 |
1467934505 | Mary Therese Block | Dentist | 2507 E Poplar Dr, Bloomington, IN 47401-4327 | 2018-09-05 |
1619456373 | Applewhite Dental Illinois, P.C. | Dentist | 2103 E Washington St Ste 1c, Bloomington, IL 61701-4365 | 2018-08-13 |
1154842581 | Anna Noel Nord | Dentist | 1404 Eastland Dr Ste 102, Bloomington, IL 61701-7904 | 2017-07-06 |
1528416302 | Nathaniel Gonzales | Dentist | 10700 France Ave S Ste 102, Bloomington, MN 55431-3693 | 2016-06-02 |
1902251911 | Optim Dental Bloomington LLC | Dentist | 401 N Veterans Pkwy Ste 4, Bloomington, IL 61704-7716 | 2016-04-27 |
1194181560 | Sleep Solutions of Central Illinois | Dentist | 2309 E. Empire St, Suite 500, Bloomington, IL 61704-8900 | 2016-01-14 |
1619353521 | Courtney Morgan | Dentist | 2306 Stern Dr, Bloomington, IL 61704-4406 | 2015-08-03 |
1508240763 | Marisa Lee Milligan | Dentist | 1404 Eastland Dr Ste 101, Bloomington, IL 61701-7904 | 2015-07-16 |
Find all providers in BLOOMINGTON |
City | BLOOMINGTON |
Zip Code | 61704 |
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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.