Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MAPLE SHADE DENTAL (DUNLAP) LLC
NPI 1134416795
Dentist in Dunlap, IL

Q: What is Maple Shade Dental (dunlap) LLC's NPI number?

The NPI number for Maple Shade Dental (dunlap) LLC is 1134416795. It was assigned to this organization in the NPPES registry on July 5, 2011.

Q: What is Maple Shade Dental (dunlap) LLC's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Active since July 05, 2011

11825 STATE ROUTE 40, SUITE 200, DUNLAP, IL 61525(309) 243-7702(309) 243-9061 Get Directions Write a Review

NPPES record last updated: July 21, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Maple Shade Dental (dunlap) Llc NPPES

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

MAPLE SHADE DENTAL (DUNLAP) LLC (NPI 1134416795) is a healthcare organization registered as a dentist in Dunlap, Illinois and active in the NPI registry since July 2011. The organization lists Victoria J Johnson, Cro, as its authorized official.

NPPES Registry Identity

NPI1134416795

Entity TypeOrganization

Primary Taxonomy122300000X

Legal Business NameMAPLE SHADE DENTAL (DUNLAP) LLC

Location Address11825 STATE ROUTE 40, SUITE 200Dunlap, IL 61525-8842

Mailing Address6240 Lake Osprey Dr Dept 56058Lakewood Ranch, FL 34240-8421

Phone(309) 243-7702

Fax(309) 243-9061

Organization SubpartNo

Authorized OfficialVictoria J JohnsonCro · (941) 444-0558

Enumeration DateJuly 5, 2011

Last NPPES UpdateJuly 21, 2026

NPPES CertifiedJuly 21, 2026

✔ NPI 1134416795 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

11825 STATE ROUTE 40, Dunlap, IL 61525

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. RODNEY EARL WILLEY DDS

Dentist

11825 STATE ROUTE 40, SUITE 100
DUNLAP, IL 61525

Peoria County (309) 243-8980

DR. GEORGE M. DUNCAN DDS

Dentist

11825 STATE ROUTE 40, SUITE 100
DUNLAP, IL 61525

Peoria County (309) 243-8980

JACKSON SLEEP CENTERS PLLC

Dentist

11825 STATE ROUTE 40, SUITE 100
DUNLAP, IL 61525

Peoria County (309) 839-9971

DR. MANLIO ZUNIGA

Dentist (Prosthodontics)

11825 STATE ROUTE 40
DUNLAP, IL 61525

Peoria County (309) 243-7702

DR. ERIN PATRICK SHANAHAN DMD

Dentist

11825 STATE ROUTE 40
DUNLAP, IL 61525

Peoria County (309) 243-7702

TIMOTHY EARL RUFFNER D.D.S.

Dentist (General Practice)

11825 STATE ROUTE 40
DUNLAP, IL 61525

Peoria County (309) 243-7702

NIZAR N MERHEB

Dentist (Oral and Maxillofacial Surgery)

11825 STATE ROUTE 40
DUNLAP, IL 61525

Peoria County (309) 243-8980

MAPLESHADE VISION CENTER INC.

Optometrist

11825 STATE ROUTE 40, SUITE 101
DUNLAP, IL 61525

Peoria County (309) 243-5900

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 Maple Shade Dental (dunlap) LLC's NPI number?

The NPI number for Maple Shade Dental (dunlap) LLC is 1134416795. It was assigned to this organization in the NPPES registry on July 5, 2011.

Where is Maple Shade Dental (dunlap) LLC located?

Maple Shade Dental (dunlap) LLC is located at 11825 State Route 40 Suite 200, Dunlap, IL 61525. The listed phone number is (309) 243-7702.

What is Maple Shade Dental (dunlap) LLC's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for Maple Shade Dental (dunlap) LLC was last updated on July 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 27 days 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.