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OPTIM DENTAL PEORIA-1 LLC
NPI 1962943290
Dentist - General Practice in Peoria, IL

Active since March 20, 2017
1200 W MAIN ST STE 9, PEORIA, IL 61606(309) 777-9777 Get Directions Write a Review

NPPES record last updated: March 20, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Optim Dental Peoria-1 Llc NPPES

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

OPTIM DENTAL PEORIA-1 LLC (NPI 1962943290) is a healthcare organization registered as a general practice in Peoria, Illinois and active in the NPI registry since March 2017. The organization lists Srinivas Durshanapalli, President, as its authorized official.

NPPES Registry Identity

NPI1962943290
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameOPTIM DENTAL PEORIA-1 LLC
Location Address1200 W MAIN ST STE 9Peoria, IL 61606-1218
Mailing Address1200 W Main St Ste 9Peoria, IL 61606-1218 · (309) 777-9777
Phone(309) 777-9777
Organization SubpartNo
Authorized OfficialSrinivas DurshanapalliPresident · (217) 303-5955
Enumeration DateMarch 20, 2017
✔ NPI 1962943290 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.
1200 W MAIN ST STE 9, Peoria, IL 61606
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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 SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware and more.Insurance ›

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.

ALLEN JAYWAN BAI DDS
Dentist (General Practice)
1200 W MAIN ST STE 9
PEORIA, IL 61606
Peoria County (425) 943-0242
ACCESS DENTAL OF PEORIA OPTIM LLC
Dentist (General Practice)
1200 W MAIN ST STE 9
PEORIA, IL 61606
Peoria County (309) 777-9777
DR. VENKAT YASHASWI KONDAPALLI
Dentist (General Practice)
1200 W MAIN ST STE 9
PEORIA, IL 61606
Peoria County (309) 777-9777
JERMIN JOSEPH DMD
Dentist
1200 W MAIN ST STE 9
PEORIA, IL 61606
Peoria County (773) 499-9385

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 Optim Dental Peoria-1 LLC's NPI number?

The NPI number for Optim Dental Peoria-1 LLC is 1962943290. It was assigned to this organization in the NPPES registry on March 20, 2017.

Where is Optim Dental Peoria-1 LLC located?

Optim Dental Peoria-1 LLC is located at 1200 W Main St Ste 9, Peoria, IL 61606. The listed phone number is (309) 777-9777.

What is Optim Dental Peoria-1 LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

What insurance does Optim Dental Peoria-1 LLC accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health and UnitedHealthcare list Optim Dental Peoria-1 LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Optim Dental Peoria-1 LLC was last updated on March 20, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.