Gregory Marshall Randolph, D,D.S.

General Practice Dentistry · Bloomington, IL

Individual Active NPI

NPI number 1801937222

Practice location

119 N Williamsburg Dr
Bloomington, IL 61704-3528
Phone
(309) 663-1326
Fax
(309) 662-3551

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NPI record

NPI
1801937222
Entity type
Individual (Type 1)
Enumeration date
February 9, 2007
Last updated
April 3, 2025
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 019-020416 IL

About Gregory Randolph

Gregory Marshall Randolph, D,D.S. is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 119 N Williamsburg Dr, Bloomington, IL 61704-3528. The NPI number 1801937222 was assigned on February 9, 2007 and the record was last updated on April 3, 2025.

Gregory Randolph lists a license in the registry: #019-020416 (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 Gregory Marshall Randolph, D,D.S.?

The NPI number is 1801937222.

What is the phone number of Gregory Randolph?

The phone number listed for the practice location is (309) 663-1326.

Where is Gregory Randolph located?

119 N Williamsburg Dr, Bloomington, IL 61704-3528.

What is the taxonomy code for Gregory Randolph?

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.

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