Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Maple Shade Dental (Dunlap) LLC

Organization Dentist · NPI 1134416795

Maple Shade Dental (Dunlap) LLC is a Dentist in Dunlap, Illinois. Registered with an NPI since 2011.

In the registry since
2011
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

11825 State Route 40 Ste 200
Dunlap, IL 61525-8842
Phone: (309) 243-7702
Fax: (309) 243-9061
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X

Record details

NPI number1134416795
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Victoria Johnson — Cro · (941) 444-0558
NPI enumeratedJuly 5, 2011
Last updated in NPPESJuly 21, 2026
Certification dateJuly 21, 2026
Mailing address6240 Lake Osprey Dr Dept 56058, Lakewood Ranch, FL 34240-8421

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