OrganizationActive
2102 Randolph Vandalia Professional, LLC
NPI 1588532675 · General Practice Dentistry · Vandalia, IL
2102 Randolph Vandalia Professional, LLC is a General Practice Dentistry organization in Vandalia, IL (NPI 1588532675).
Provider details
- NPI number
- 1588532675
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Pam Draper, Vp of Operations(602) 391-4086
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(54/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in 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
2102 W Randolph St
Vandalia, IL 62471-1973
Phone: (618) 283-4900
Street-level locationGet directions
Mailing address
2102 W Randolph St
Vandalia, IL 62471-1973
Registry dates
- Enumerated
- 2025-10-29
- Last updated
- 2025-10-29
- Certified
- 2025-10-29
Frequently asked questions
- What is 2102 Randolph Vandalia Professional, LLC's NPI number?
- 2102 Randolph Vandalia Professional, LLC's National Provider Identifier (NPI) is 1588532675, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is 2102 Randolph Vandalia Professional, LLC?
- 2102 Randolph Vandalia Professional, LLC is classified in the NPPES registry as General Practice Dentistry (Dental Providers).
- Where is 2102 Randolph Vandalia Professional, LLC located?
- 2102 Randolph Vandalia Professional, LLC's practice location on file with NPPES is 2102 W Randolph St, Vandalia, IL 62471-1973.
- What is 2102 Randolph Vandalia Professional, LLC's phone number?
- The practice phone number listed in the NPPES registry for 2102 Randolph Vandalia Professional, LLC is (618) 283-4900.
- Who is the authorized official for 2102 Randolph Vandalia Professional, LLC?
- The authorized official listed on 2102 Randolph Vandalia Professional, LLC's NPPES record is Pam Draper, Vp of Operations. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is 2102 Randolph Vandalia Professional, LLC's NPI active?
- Yes — 2102 Randolph Vandalia Professional, LLC's NPI (1588532675) is active in the NPPES registry as of the last update on 2025-10-29.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.