Granite City Dental Care Ltd
NPI 1750609418ActiveOrganization· Dentist· Champaign, IL
Dentist in Champaign, Illinois, registered in NPPES in May 2010, part of Granite City Dental Care. The authorized official on file is La Nae Wood, Office Manager.
Overview
| NPI | 1750609418 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Granite City Dental Care |
| NPI issued | May 5, 2010 |
| Last updated in NPPES | May 5, 2010 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist Primary | 122300000X | 019.0225511 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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