CHERRYVALE DENTAL CENTER LLC
NPI 1669094041
Clinic/Center - Dental in Rockford, IL
NPI Status: Active since May 08, 2020
Contact Information
1957 PAWLISCH DR
ROCKFORD, IL
ZIP 61112
Phone: (815) 332-3477
Fax: (815) 332-3470
- Organization
- Clinic/Center
- Dental
- CLIA Number: 14D0429570
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 02-09-2026
About CHERRYVALE DENTAL CENTER LLC
This page provides the complete NPI Profile along with additional information for Cherryvale Dental Center Llc, a provider established in Rockford, Illinois operating as a Clinic/center, focusing in dental . The healthcare provider is registered in the NPI registry with number 1669094041 assigned on May 2020. The practitioner's primary taxonomy code is 261QD0000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The authorized official of this NPI record is Bart Paul Dds (Sole Member)
- NPI
- 1669094041
- Provider Name
- CHERRYVALE DENTAL CENTER LLC
- Entity Type
- Organization
- Location Address
- 1957 PAWLISCH DR ROCKFORD, IL 61112
- Location Phone
- (815) 332-3477
- Location Fax
- (815) 332-3470
- Mailing Address
- 1957 PAWLISCH DR ROCKFORD, IL 61112
- Mailing Phone
- (815) 332-3477
- Mailing Fax
- (815) 332-3470
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-08-2020
- Last Update Date
- 05-08-2020
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Dental
- Taxonomy Code
- 261QD0000X
- Type
- Ambulatory Health Care Facilities
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 14D0429570
- Facility Type
- Physician Office
- Certificate Effective Date
- February 10, 2024
- Certificate Expiration Date
- February 09, 2026
- Laboratory Director
- CRAIG S. MICHELSEN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Cherryvale Dental Center Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1669094041, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 69. The final step is to find the difference between that total and the next multiple of ten (70 - 69 = 1).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 69 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1669094041, enumerated as an "organization" on May 08, 2020.
The provider is located at 1957 PAWLISCH DR ROCKFORD, IL 61112 and the phone number is (815) 332-3477.
Clinic/Center with taxonomy code 261QD0000X and a focus in Dental.
