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PINE GLEN DENTAL GROUP, LTD
NPI 1659589299
Dentist - General Practice in Peoria, IL

Active since May 18, 2007
838 W GLEN AVE, PEORIA, IL 61614(309) 691-1990(309) 691-9112 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Pine Glen Dental Group, Ltd NPPES

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

PINE GLEN DENTAL GROUP, LTD (NPI 1659589299) is a healthcare organization registered as a general practice in Peoria, Illinois and active in the NPI registry since May 2007. The organization lists Robert Michael Pollard, President, as its authorized official.

NPPES Registry Identity

NPI1659589299
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NamePINE GLEN DENTAL GROUP, LTD
Location Address838 W GLEN AVEPeoria, IL 61614-4835
Mailing Address838 W Glen AvePeoria, IL 61614-4835 · (309) 691-1990 · Fax (309) 691-9112
Phone(309) 691-1990
Fax(309) 691-9112
Organization SubpartNo
Authorized OfficialRobert Michael PollardPresident · (309) 691-1990
Enumeration DateMay 18, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1659589299 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.

838 W GLEN AVE, Peoria, IL 61614
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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 MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

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

DR. LORI ANNE POLLARD RICE DDS
Dentist (General Practice)
838 W GLEN AVE
PEORIA, IL 61614
Peoria County (309) 691-1990
DR. ROBERT MICHAEL POLLARD DDS
Dentist (General Practice)
838 W GLEN AVE
PEORIA, IL 61614
Peoria County (309) 691-1990
DR. ERIC THOMAS SUDHOLT D.M.D.
Dentist
838 W GLEN AVE
PEORIA, IL 61614
Peoria County (309) 691-1990
PINE GLEN DENTAL GROUP, LTD
Dentist (General Practice)
838 W GLEN AVE
PEORIA, IL 61614
Peoria County (309) 691-1990

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 Pine Glen Dental Group, Ltd's NPI number?

The NPI number for Pine Glen Dental Group, Ltd is 1659589299. It was assigned to this organization in the NPPES registry on May 18, 2007.

Where is Pine Glen Dental Group, Ltd located?

Pine Glen Dental Group, Ltd is located at 838 W Glen Ave, Peoria, IL 61614. The listed phone number is (309) 691-1990.

What is Pine Glen Dental Group, Ltd'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 Pine Glen Dental Group, Ltd was last updated on August 22, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.