IndividualActive
Jon Dively, DDS
NPI 1659596393 · General Practice Dentistry · Macomb, IL
Jon Dively, DDS is a General Practice Dentistry provider in Macomb, IL (NPI 1659596393).
Provider details
- NPI number
- 1659596393
- Entity type
- Individual
- Primary specialty
- General Practice DentistryDental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- Yes
- License
- 19A13962 (IL)
Practice location
4 Doctors Ln
Macomb, IL 61455-3376
Phone: (309) 837-3918
Street-level locationGet directions
Mailing address
4 Doctors Ln
Macomb, IL 61455-3376
Registry dates
- Enumerated
- 2007-04-16
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.