OrganizationActive
Maryville Family Dental
NPI 1639405731 · Dentist · Maryville, IL
Maryville Family Dental is a Dentist organization in Maryville, IL (NPI 1639405731).
Provider details
- NPI number
- 1639405731
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Organization subpart
- No
- Authorized official
- Amanda Henderson, Accounts Payable(618) 288-6201
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(84/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 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
2921 North Center Street
Suite 8-9
Maryville, IL 62062
Phone: (618) 288-7804
Fax: (618) 288-7918
Street-level locationGet directions
Mailing address
26 Ginger Creek Pkwy
Glen Carbon, IL 62034-3502
Registry dates
- Enumerated
- 2009-10-23
- Last updated
- 2012-10-08
Frequently asked questions
- What is Maryville Family Dental's NPI number?
- Maryville Family Dental's National Provider Identifier (NPI) is 1639405731, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Maryville Family Dental?
- Maryville Family Dental is classified in the NPPES registry as Dentist (Dental Providers).
- Where is Maryville Family Dental located?
- Maryville Family Dental's practice location on file with NPPES is 2921 North Center Street, Maryville, IL 62062.
- What is Maryville Family Dental's phone number?
- The practice phone number listed in the NPPES registry for Maryville Family Dental is (618) 288-7804.
- Who is the authorized official for Maryville Family Dental?
- The authorized official listed on Maryville Family Dental's NPPES record is Amanda Henderson, Accounts Payable. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Maryville Family Dental's NPI active?
- Yes — Maryville Family Dental's NPI (1639405731) is active in the NPPES registry as of the last update on 2012-10-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.