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Maple Shade Dental Camp Street LLC

Dentist in East Peoria, IL · enumerated 2012 · authorized official Victoria Johnson, Cro.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1497003156

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Registry record

Entity type Organization (Type 2)
Legal business name Maple Shade Dental Camp Street LLC
Practice address 809 W Camp St, East Peoria, IL, 61611
Phone (309) 694-0606
Enumeration date Aug 28, 2012
Last updated in NPPES Jul 21, 2026

Taxonomy & classification

122300000X Dentist Dental Providers Primary

Authorized official

Name Victoria Johnson
Title Cro
Phone (941) 444-0558

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Maple Shade Dental Camp Street LLC?
The NPI for Maple Shade Dental Camp Street LLC is 1497003156, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Maple Shade Dental Camp Street LLC?
NPPES lists Victoria Johnson (Cro) as the authorized official for this organization.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2026-07-21.