1. Home
  2. Directory
  3. Illinois
  4. Highland
  5. Dentist
  6. NPI Profile

CEDAR CREEK DENTAL PLLC
NPI 1063132926
Dentist - General Practice in Highland, IL

Active since August 31, 2022
380 SUPPIGER WAY # A, HIGHLAND, IL 62249(618) 654-4551 Get Directions Write a Review

NPPES record last updated: September 20, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 20, 2022, Aug 31, 2022 (2 updates tracked since 2022).

About Cedar Creek Dental Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CEDAR CREEK DENTAL PLLC (NPI 1063132926) is a healthcare organization registered as a general practice in Highland, Illinois and active in the NPI registry since August 2022. The organization lists Jared Crutcher, Dentist, as its authorized official.

NPPES Registry Identity

NPI1063132926
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameCEDAR CREEK DENTAL PLLC
Location Address380 SUPPIGER WAY # AHighland, IL 62249-1103
Mailing Address380 Suppiger Way # AHighland, IL 62249-1103 · (618) 654-4551
Phone(618) 654-4551
Organization SubpartNo
Authorized OfficialJared CrutcherDentist · (618) 654-4551
Enumeration DateAugust 31, 2022
Last NPPES UpdateSeptember 20, 20222 updates tracked since enumeration
NPPES CertifiedSeptember 20, 2022
✔ NPI 1063132926 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
380 SUPPIGER WAY # A, Highland, IL 62249
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Cedar Creek Dental PLLC's NPI number?

The NPI number for Cedar Creek Dental PLLC is 1063132926. It was assigned to this organization in the NPPES registry on August 31, 2022.

Where is Cedar Creek Dental PLLC located?

Cedar Creek Dental PLLC is located at 380 Suppiger Way # A, Highland, IL 62249. The listed phone number is (618) 654-4551.

What is Cedar Creek Dental PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Cedar Creek Dental PLLC was last updated on September 20, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.