1. Home
  2. Directory
  3. Illinois
  4. Peoria
  5. Dentist
  6. NPI Profile

SMALLTOWN DENTAL WILLOW KNOLLS LLC
NPI 1699365809
Dentist - General Practice in Peoria, IL

Active since January 21, 2021
6712 N MOUNTELLO DR, PEORIA, IL 61614(309) 691-7855 Get Directions Write a Review

NPPES record last updated: January 21, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Smalltown Dental Willow Knolls Llc NPPES

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

SMALLTOWN DENTAL WILLOW KNOLLS LLC (NPI 1699365809), doing business as Smalltown Dental Willow Knolls, is a healthcare organization registered as a general practice in Peoria, Illinois and active in the NPI registry since January 2021. The organization lists Luke Overcash, Operations Manager, as its authorized official.

NPPES Registry Identity

NPI1699365809
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameSMALLTOWN DENTAL WILLOW KNOLLS LLC
Location Address6712 N MOUNTELLO DRPeoria, IL 61614-2328
Mailing Address6712 N Mountello DrPeoria, IL 61614-2328 · (309) 691-7855
Phone(309) 691-7855
Organization SubpartYesParent: Smalltown Dental Management Llc
Authorized OfficialLuke OvercashOperations Manager · (309) 370-5853
Enumeration DateJanuary 21, 2021
NPPES CertifiedJanuary 21, 2021
✔ NPI 1699365809 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.
6712 N MOUNTELLO DR, Peoria, IL 61614
Open in Google Maps ↗

Other Names 1

Doing Business AsSmalltown Dental Willow Knolls

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

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

MICHAEL MOMCHEV DDS
Dentist (General Practice)
6712 N MOUNTELLO DR
PEORIA, IL 61614
Peoria County (309) 691-7855
RICHARD T. MOON, D.D.S., P.C.
Dentist (General Practice)
6712 N MOUNTELLO DR
PEORIA, IL 61614
Peoria County (309) 691-7855
DR. RICHARD T MOON DDS
Dentist (General Practice)
6712 N MOUNTELLO DR
PEORIA, IL 61614
Peoria County (309) 691-7855

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 Smalltown Dental Willow Knolls LLC's NPI number?

The NPI number for Smalltown Dental Willow Knolls LLC is 1699365809. It was assigned to this organization in the NPPES registry on January 21, 2021. The provider is doing business as Smalltown Dental Willow Knolls.

Where is Smalltown Dental Willow Knolls LLC located?

Smalltown Dental Willow Knolls LLC is located at 6712 N Mountello Dr, Peoria, IL 61614. The listed phone number is (309) 691-7855.

What is Smalltown Dental Willow Knolls LLC'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 Smalltown Dental Willow Knolls LLC was last updated on January 21, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.