OrganizationActive
Maple Shade Dental Group
NPI 1427116854 · Oral and Maxillofacial Surgery (Dentist) · Dunlap, IL
Provider details
- NPI number
- 1427116854
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Organization subpart
- No
- Authorized official
- Rodney Willey, Ceo(309) 243-7702
Specialties & taxonomies
Dental Providers
- General Practice Dentistry1223G0001X
Dental Providers
- Periodontics1223P0300X
Dental Providers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 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
11825 N Knoxville Ave
Dunlap, IL 61525
Phone: (309) 243-7702
Fax: (309) 243-9559
Street-level locationGet directions
Mailing address
11825 N Knoxville Ave
Dunlap, IL 61525
Registry dates
- Enumerated
- 2006-12-05
- Last updated
- 2025-09-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.