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

Optim Dental Peoria-1 LLC

Organization General Practice Dentistry · NPI 1962943290

Optim Dental Peoria-1 LLC is a General Practice Dentistry in Peoria, Illinois. Registered with an NPI since 2017.

In the registry since
2017
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

1200 W Main St Ste 9
Peoria, IL 61606-1218
Phone: (309) 777-9777
Show map & directions

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

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X

Record details

NPI number1962943290
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Srinivas Durshanapalli — President · (217) 303-5955
NPI enumeratedMarch 20, 2017
Last updated in NPPESMarch 20, 2017
Mailing address1200 W Main St Ste 9, Peoria, IL 61606-1218

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