Affinity Dental Peoria Heights LLC
Dentist, General Practice in Peoria Heights, IL. Organization (NPI-2).
NPI number1093642001
StatusActive
Last updated in NPPESMay 5, 2026
Details
- NPI
- 1093642001
- Entity type
- Organization (NPI-2)
- Legal business name
- Affinity Dental Peoria Heights LLC
- Organization subpart
- No
- Enumeration date
- May 5, 2026
- Certification date
- May 5, 2026
- Last updated
- May 5, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
| 261QD0000X | Clinic/Center, Dental | – | – |
Practice location
4450 N Prospect Rd Ste S5Peoria Heights, IL 61616-6578
Phone 309-327-3333 · Fax 309-561-7333
Mailing address
4450 N Prospect Rd Ste S5Peoria Heights, IL 61616-6578
Phone 309-327-3333 · Fax 309-561-7333
Authorized official
Srinivas Durshanapalli
President
8882448899
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other General Practice Dentistry providers in Peoria Heights, IL
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.