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NPI 1154715795ActiveIndividual· Dentist· Alton, IL
Dentist in Alton, Illinois, licensed in IL, with an NPI issued in March 2015. Part D covered 46 prescriptions written in 2024, 98% of them generic.
Overview
| NPI | 1154715795 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Mar 21, 2015 |
| Last updated in NPPES | Mar 21, 2015 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist Primary | 122300000X | 019.030120 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Oral Surgery (MN) |
|---|
Part D prescriptions in 2024
| Prescriptions (claims) | 46 · 46 30-day fills |
|---|---|
| Patients | 32 |
| Total drug cost | $554.81 |
| Generic share | 98% of claims |
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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