Jon Karl Dively, DDS

General Practice Dentistry · Macomb, IL

Individual Active NPI

NPI number 1659596393

Practice location

4 Doctors Ln
Macomb, IL 61455-3376
Phone
(309) 837-3918

Open in Google Maps

NPI record

NPI
1659596393
Entity type
Individual (Type 1)
Enumeration date
April 16, 2007
Last updated
July 8, 2007
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 19A13962 IL

About Dr. Dively

Jon Karl Dively, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 4 Doctors Ln, Macomb, IL 61455-3376. The NPI number 1659596393 was assigned on April 16, 2007 and the record was last updated on July 8, 2007.

Dr. Dively lists a license in the registry: #19A13962 (IL) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jon Karl Dively, DDS?

The NPI number is 1659596393.

What is the phone number of Dr. Dively?

The phone number listed for the practice location is (309) 837-3918.

Where is Dr. Dively located?

4 Doctors Ln, Macomb, IL 61455-3376.

What is the taxonomy code for Dr. Dively?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

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.

Other General Practice Dentistry providers in Macomb

All General Practice Dentistry providers in Macomb, IL →