OrganizationActive
Maple Shade Dental Camp Street LLC
NPI 1497003156 · Dentist · East Peoria, IL
Maple Shade Dental Camp Street LLC is a Dentist organization in East Peoria, IL (NPI 1497003156).
Provider details
- NPI number
- 1497003156
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Organization subpart
- No
- Authorized official
- Mike Cole, Insurance Director(727) 726-1611
Specialties & taxonomies
Dental Providers
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
13 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
809 W Camp St
East Peoria, IL 61611-7218
Phone: (309) 694-0606
Street-level locationGet directions
Mailing address
809 W Camp St
East Peoria, IL 61611-7218
Registry dates
- Enumerated
- 2012-08-28
- Last updated
- 2012-08-28
Frequently asked questions
- What is Maple Shade Dental Camp Street LLC's NPI number?
- Maple Shade Dental Camp Street LLC's National Provider Identifier (NPI) is 1497003156, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Maple Shade Dental Camp Street LLC?
- Maple Shade Dental Camp Street LLC is classified in the NPPES registry as Dentist (Dental Providers).
- Where is Maple Shade Dental Camp Street LLC located?
- Maple Shade Dental Camp Street LLC's practice location on file with NPPES is 809 W Camp St, East Peoria, IL 61611-7218.
- What is Maple Shade Dental Camp Street LLC's phone number?
- The practice phone number listed in the NPPES registry for Maple Shade Dental Camp Street LLC is (309) 694-0606.
- Who is the authorized official for Maple Shade Dental Camp Street LLC?
- The authorized official listed on Maple Shade Dental Camp Street LLC's NPPES record is Mike Cole, Insurance Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Maple Shade Dental Camp Street LLC's NPI active?
- Yes — Maple Shade Dental Camp Street LLC's NPI (1497003156) is active in the NPPES registry as of the last update on 2012-08-28.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.