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: July 19, 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
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

Accepted 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.

Dentist (General Practice)
208 N WALNUT AVE
FORRESTON, IL 61030

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1437703113, enumerated as an "organization" on July 30, 2019.

The provider is located at 208 N WALNUT AVE FORRESTON, IL 61030 and the phone number is (815) 938-2575.

Clinic/Center with taxonomy code 261QS0112X and a focus in Oral and Maxillofacial Surgery.

The provider might be accepting Accepts: UnitedHealthcare. Please consult your insurance carrier or call the provider to verify.