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SHADY OAK DENTAL LLC ORAL AND MAXILLOFACIAL SURGEONS OF NORTHWEST IL
NPI 1437703113
Clinic/Center - Oral and Maxillofacial Surgery in Forreston, IL

Active since July 30, 2019
208 N WALNUT AVE, FORRESTON, IL 61030(815) 938-2575 Get Directions Write a Review

NPPES record last updated: July 30, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Shady Oak Dental Llc Oral And Maxillofacial Surgeons Of Northwest Il NPPES

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

SHADY OAK DENTAL LLC ORAL AND MAXILLOFACIAL SURGEONS OF NORTHWEST IL (NPI 1437703113) is a healthcare organization registered as an oral and maxillofacial surgery in Forreston, Illinois and active in the NPI registry since July 2019. The organization lists Scott C Bares, President, as its authorized official.

NPPES Registry Identity

NPI1437703113
Entity TypeOrganization
Primary Taxonomy261QS0112X
Legal Business NameSHADY OAK DENTAL LLC ORAL AND MAXILLOFACIAL SURGEONS OF NORTHWEST IL
Location Address208 N WALNUT AVEForreston, IL 61030-9330
Mailing Address208 N Walnut AveForreston, IL 61030-9330 · (815) 938-2575
Phone(815) 938-2575
Organization SubpartNo
Authorized OfficialScott C BaresPresident · (815) 938-2575
Enumeration DateJuly 30, 2019
✔ NPI 1437703113 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Oral and Maxillofacial SurgeryAmbulatory Health Care Facilities
Taxonomy Code261QS0112X
Definition
An oral and maxillofacial surgery clinic or center specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
208 N WALNUT AVE, Forreston, IL 61030
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Other Providers at the Same Location NPPES

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

DR. KEITH R. RUTER D.D.S.
Dentist (General Practice)
208 N WALNUT AVE
FORRESTON, IL 61030
Ogle County (815) 938-2575

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 Shady Oak Dental LLC Oral And Maxillofacial Surgeons Of Northwest Il's NPI number?

The NPI number for Shady Oak Dental LLC Oral And Maxillofacial Surgeons Of Northwest Il is 1437703113. It was assigned to this organization in the NPPES registry on July 30, 2019.

Where is Shady Oak Dental LLC Oral And Maxillofacial Surgeons Of Northwest Il located?

Shady Oak Dental LLC Oral And Maxillofacial Surgeons Of Northwest Il is located at 208 N Walnut Ave, Forreston, IL 61030. The listed phone number is (815) 938-2575.

What is Shady Oak Dental LLC Oral And Maxillofacial Surgeons Of Northwest Il's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Oral and Maxillofacial Surgery, with taxonomy code 261QS0112X.

What insurance does Shady Oak Dental LLC Oral And Maxillofacial Surgeons Of Northwest Il accept?

Health plans from UnitedHealthcare list Shady Oak Dental LLC Oral And Maxillofacial Surgeons Of Northwest Il as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shady Oak Dental LLC Oral And Maxillofacial Surgeons Of Northwest Il was last updated on July 30, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.