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

Mountain Bay Dental LLC

Organization General Practice Dentistry · NPI 1295268019

Mountain Bay Dental LLC is a General Practice Dentistry in Champaign, Illinois. Licensed in Wisconsin. Registered with an NPI since 2017.

Licensed in
WI
In the registry since
2017
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

3510 Marianna Dr
Champaign, IL 61822-9502
Phone: (715) 496-1128
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 1001483 (WI)

Record details

NPI number1295268019
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lanae Johnson — Manager · (715) 496-1128
NPI enumeratedApril 8, 2017
Last updated in NPPESApril 8, 2017
Mailing address5702 Memorial Ct, Weston, WI 54476-6502

Other providers in Champaign