Sara Renee Rauen Dardis in Bloomington - Pediatric Dentistry
Sara Renee Rauen Dardis - NPI 1558465583
Sara Renee Rauen Dardis is a Pediatric Dentistry in Bloomington, Illinois. Sara Renee Rauen Dardis practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Sara Renee Rauen Dardis is 1558465583. The last update date is 2021-02-12.
Sara Renee Rauen Dardis's current location address is 1112 Trinity Ln, Bloomington, Illinois. You can contact this provider via phone number 3096637339 and fax number 3096637173. The mailing address for Sara Renee Rauen Dardis is 1112 Trinity Ln, Bloomington, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Sara Renee Rauen Dardis |
|---|---|
| Address | 1112 Trinity Ln, Bloomington, Illinois |
| Phone Number | 3096637339 |
| Fax Number | 3096637173 |
| Sole Proprietor | N |
| Credentials | DDS, MS |
NPI Number Detail
| NPI Number | 1558465583 |
|---|---|
| Provider Enumeration Date | 2006-09-11 |
| Last Updated Date | 2021-02-12 |
Provider Mailing Address Detail
| Address | 1112 Trinity Ln |
|---|---|
| City | Bloomington |
| State | Illinois (IL) |
| Post Code | 617048109 |
| Phone Number | 3096637339 |
| Fax Number | 3096637173 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | 21002032 |
|
Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 29040 | BLUECROSSBLUESHIELD FEDERAL |
Post Comment/ Review Below
What is the unique provider identifier assigned to Sara Renee Rauen Dardis?
The Sara Renee Rauen Dardis has been issued the NPI (National Provider Identifier) 1558465583 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you share the physical location details of Sara Renee Rauen Dardis?
The Sara Renee Rauen Dardis is situated at 1112 Trinity Ln, in the city of Bloomington, state of IL, with the zip code 617048109.
What is the Sara Renee Rauen Dardis's area of specialization and corresponding taxonomy classification?
The Sara Renee Rauen Dardis's specialty field is Pediatric Dentistry, and it falls under the taxonomy code 1223P0221X, which categorizes healthcare providers based on their specialties.
On what date was the 1558465583 assigned to Sara Renee Rauen Dardis?
The Sara Renee Rauen Dardis was issued its 1558465583 on 2006-09-11, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
When was the Sara Renee Rauen Dardis's information last updated?
The Sara Renee Rauen Dardis's information was last updated on 2021-02-12.