FAMILIA DENTAL – NPI #1932429164
Clinic/Center

FAMILIA DENTAL is an AHC clinic located in PEORIA, IL. NPPES has assigned the NPI number 1932429164 to FAMILIA DENTAL on June 10, 2010. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “FAMILIA DENTAL” is a dba name, the actual legal business name for this organization is FAMILIA DENTAL PEORIA LLC. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QD0000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Dental

The NPI profile was previously updated about 5 years ago on Oct 21, 2021. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for FAMILIA DENTAL below.

NPI Profile for
FAMILIA DENTAL PEORIA LLC

NPI Number
1932429164
Enumeration Date

(more than 16 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
FAMILIA DENTAL PEORIA LLC
Doing Business As (dba): FAMILIA DENTAL
Primary location
1403 W. GLEN
PEORIA, IL 61614
Phone: (888) 988-4066 Fax:
Mailing address
2050 E ALGONQUIN ROAD
SUITE 610
SCHAUMBURG, IL 60173-4166
Phone: (847) 453-7396 Fax: (847) 453-7396
Organization Subpart
No
Authorized Official
BRANDON TAYLOR
CREDENTIALING & PAYER RELATIONS
Phone: (847) 453-7396
Updated
Certification Date
Oct 21, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QD0000X
- Clinic/Center / Dental (Primary)
1223G0001X
- Dentist / General Practice

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.