OrganizationActive
Mountain Bay Dental LLC
NPI 1295268019 · General Practice Dentistry · Champaign, IL
Mountain Bay Dental LLC is a General Practice Dentistry organization in Champaign, IL (NPI 1295268019).
Provider details
- NPI number
- 1295268019
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Lanae Johnson, Manager(715) 496-1128
- License
- 1001483 (WI)
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(70/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3510 Marianna Dr
Champaign, IL 61822-9502
Phone: (715) 496-1128
Street-level locationGet directions
Mailing address
5702 Memorial Ct
Weston, WI 54476-6502
Registry dates
- Enumerated
- 2017-04-08
- Last updated
- 2017-04-08
Frequently asked questions
- What is Mountain Bay Dental LLC's NPI number?
- Mountain Bay Dental LLC's National Provider Identifier (NPI) is 1295268019, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Mountain Bay Dental LLC?
- Mountain Bay Dental LLC is classified in the NPPES registry as General Practice Dentistry (Dental Providers).
- Where is Mountain Bay Dental LLC located?
- Mountain Bay Dental LLC's practice location on file with NPPES is 3510 Marianna Dr, Champaign, IL 61822-9502.
- What is Mountain Bay Dental LLC's phone number?
- The practice phone number listed in the NPPES registry for Mountain Bay Dental LLC is (715) 496-1128.
- Who is the authorized official for Mountain Bay Dental LLC?
- The authorized official listed on Mountain Bay Dental LLC's NPPES record is Lanae Johnson, Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Mountain Bay Dental LLC's NPI active?
- Yes — Mountain Bay Dental LLC's NPI (1295268019) is active in the NPPES registry as of the last update on 2017-04-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.