Total Health Dentistry

LBN: Hawkeye Dental Creations
Total Health Dentistry is an health care organization with primary practice located at 615 35Th Avenue , Moline IL 61265. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Hawkeye Dental Creations can be contacted via phone (309) 762-3015, or through Richardson, Jacquelyn Leah via phone (309) 762-3015.

Contact Information

Primary practice address
615 35Th Avenue Moline IL 61265
Phone: (309) 762-3015
Fax: (309) 762-1461
Website:
Map and Directions
Authorized official contact:
Name: Richardson, Jacquelyn Leah Doctor of Dental Surgery (DDS)
Phone: (309) 762-3015

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 019026572 Illinois

Profile Details

NPI number 1649305921
LBN Legal business name Hawkeye Dental Creations
DBA Doing business as Total Health Dentistry
Authorized official Richardson, Jacquelyn Leah Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 23rd, 2007
Last updated Jun 25th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649305921 NPPES
Illinois MEDICAID 110282

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