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HAWKEYE DENTAL CREATIONS NPI 1649305921


NPI Information

NPI: 1649305921
Provider Name: HAWKEYE DENTAL CREATIONS

Doing Business As: TOTAL HEALTH DENTISTRY

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
615 35TH AVENUE
MOLINE, IL
ZIP 61265
Phone: (309) 762-3015
Get Directions

HAWKEYE DENTAL CREATIONS is a general practice dentist in Moline, IL. The provider is 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. HAWKEYE DENTAL CREATIONS NPI is 1649305921. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Total Health Dentistry.

The provider's business location address is:

615 35TH AVENUE
MOLINE, IL
ZIP 61265
Phone: (309) 762-3015
Fax: (309) 762-1461

The provider's authorized official is Jacquelyn Leah Richardson .
The authorized official title is President Dentist and has the following contact phone number (309) 762-3015.

The enumeration date for this NPI number is 2/23/2007 and was last updated on 6/25/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice019026572ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1110282MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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