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TAZEWELL COUNTY HEALTH DEPARTMENT -DENTAL HEALTH CENTER
NPI 1649308230
Public Health or Welfare in North Pekin, IL

Active since March 02, 2007CLIA 14D0431738 · Waiver
135 RADIO CITY DRIVE, SUITE A & B, NORTH PEKIN, IL 61554(309) 382-2229(309) 382-1155 Get Directions Write a Review

NPPES record last updated: June 20, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Tazewell County Health Department -dental Health Center NPPES

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

TAZEWELL COUNTY HEALTH DEPARTMENT -DENTAL HEALTH CENTER (NPI 1649308230) is a healthcare organization registered as a public health or welfare in North Pekin, Illinois and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through December 20, 2027 and lists Jerry Lee Marshall, Director Of Dental Services, as its authorized official.

NPPES Registry Identity

NPI1649308230
Entity TypeOrganization
Primary Taxonomy251K00000X
Legal Business NameTAZEWELL COUNTY HEALTH DEPARTMENT -DENTAL HEALTH CENTER
Location Address135 RADIO CITY DRIVE, SUITE A & BNorth Pekin, IL 61554
Mailing Address135 Radio City Drive, Suite A & BNorth Pekin, IL 61554 · (309) 382-2229 · Fax (309) 382-1155
Phone(309) 382-2229
Fax(309) 382-1155
Organization SubpartNo
Authorized OfficialJerry Lee MarshallDirector Of Dental Services · (309) 382-2229
Enumeration DateMarch 2, 2007
Last NPPES UpdateJune 20, 2008
✔ NPI 1649308230 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPublic Health or WelfareAgencies
Taxonomy Code251K00000X
License✔ Licensed in IL · E9993-0978-05
135 RADIO CITY DRIVE, North Pekin, IL 61554
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D0431738

Tazewell County Health Department · Pekin, IL
Active · expires Dec 20, 2027
CLIA Number14D0431738
Laboratory TypeOther
Certificate Effective DateDecember 21, 2025
Certificate Expiration DateDecember 20, 2027
Laboratory DirectorSarah R. Koscica M D
Laboratory Phone(309) 929-0236
Laboratory LocationTazewell County Health Department1800 Broadway St, Pekin, IL 61554
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

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 Tazewell County Health Department -Dental Health Center's NPI number?

The NPI number for Tazewell County Health Department -Dental Health Center is 1649308230. It was assigned to this organization in the NPPES registry on March 2, 2007.

Where is Tazewell County Health Department -Dental Health Center located?

Tazewell County Health Department -Dental Health Center is located at 135 Radio City Drive Suite A & B, North Pekin, IL 61554. The listed phone number is (309) 382-2229.

What is Tazewell County Health Department -Dental Health Center's specialty?

The primary specialty registered for this NPI is Public Health or Welfare with taxonomy code 251K00000X.

Does Tazewell County Health Department -Dental Health Center hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D0431738) is associated with this NPI, valid through December 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Tazewell County Health Department -Dental Health Center was last updated on June 20, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.