Carl Thomas Drake, D.D.S., M.S.

Dentist · Normal, IL

Individual Active NPI

NPI number 1124227228

Practice location

310 Susan Dr
Ste 1
Normal, IL 61761-6206
Phone
(309) 808-0054

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NPI record

NPI
1124227228
Entity type
Individual (Type 1)
Enumeration date
July 17, 2007
Last updated
May 27, 2011
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X 019.027428 IL
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 021.002368 IL

Mailing address

310 Susan Drive, Suite 1
Normal, IL 61761
Phone
(309) 808-0054

About Dr. Drake

Carl Thomas Drake, D.D.S., M.S. is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 310 Susan Dr, Ste 1, Normal, IL 61761-6206. The NPI number 1124227228 was assigned on July 17, 2007 and the record was last updated on May 27, 2011.

Dr. Drake lists 2 licenses in the registry: #019.027428 (IL) for Dentist; #021.002368 (IL) for Orthodontics and Dentofacial Orthopedics Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Carl Thomas Drake, D.D.S., M.S.?

The NPI number is 1124227228.

What is the phone number of Dr. Drake?

The phone number listed for the practice location is (309) 808-0054.

Where is Dr. Drake located?

310 Susan Dr, Ste 1, Normal, IL 61761-6206.

What is the taxonomy code for Dr. Drake?

The primary taxonomy code is 122300000X – Dentist; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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