OrganizationActive
Peoria Dental LLC
NPI 1992202139 · Dental Clinic/Center · Peoria, IL
Provider details
- NPI number
- 1992202139
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Scott Bares, President(309) 981-5995
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(68/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 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
7417 N Knoxville Ave
Peoria, IL 61614-2019
Phone: (309) 981-5995
Fax: (309) 981-5981
Street-level locationGet directions
Mailing address
7417 N Knoxville Ave
Peoria, IL 61614-2019
Registry dates
- Enumerated
- 2018-04-12
- Last updated
- 2018-04-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.