OrganizationActive
Decatur 2012 LLC
NPI 1306107578 · Dental Clinic/Center · Decatur, IL
Decatur 2012 LLC is a Dental Clinic/Center organization in Decatur, IL (NPI 1306107578).
Provider details
- NPI number
- 1306107578
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Brandon Taylor, Credentialing Payer Relations Mgr(847) 453-7396
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(79/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 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
141 E Pershing Rd
Decatur, IL 62526-3213
Phone: (888) 988-4066
Fax: (847) 496-7603
Street-level locationGet directions
Mailing address
2050 E Algonquin Rd
Schaumburg, IL 60173-4144
Other names (DBA / former)
- Doing business as
- Family Dental
Registry dates
- Enumerated
- 2012-06-05
- Last updated
- 2021-10-15
- Certified
- 2021-10-15
Frequently asked questions
- What is Decatur 2012 LLC's NPI number?
- Decatur 2012 LLC's National Provider Identifier (NPI) is 1306107578, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Decatur 2012 LLC?
- Decatur 2012 LLC is classified in the NPPES registry as Dental Clinic/Center (Ambulatory Health Care Facilities).
- Where is Decatur 2012 LLC located?
- Decatur 2012 LLC's practice location on file with NPPES is 141 E Pershing Rd, Decatur, IL 62526-3213.
- What is Decatur 2012 LLC's phone number?
- The practice phone number listed in the NPPES registry for Decatur 2012 LLC is (888) 988-4066.
- Who is the authorized official for Decatur 2012 LLC?
- The authorized official listed on Decatur 2012 LLC's NPPES record is Brandon Taylor, Credentialing Payer Relations Mgr. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Decatur 2012 LLC's NPI active?
- Yes — Decatur 2012 LLC's NPI (1306107578) is active in the NPPES registry as of the last update on 2021-10-15.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.