Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. GREGORY MARSHALL RANDOLPH, D,D.S.
Active Sole ProprietorDR. GREGORY MARSHALL RANDOLPH, D,D.S. is a General Dentistry healthcare provider located in BLOOMINGTON, Illinois. NPI 1801937222 is currently active in the NPPES registry. Verify at CMS.
General Dentistry · BLOOMINGTON, IL
Registration Details
- NPI Number
- 1801937222
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 9, 2007 (19.527003354601 yrs)
- Last Updated
- Apr 3, 2025
- License
-
019-020416 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
119 N WILLIAMSBURG DRBLOOMINGTON, IL, 617043528Browse IL providers · Browse ZIP 61704
- Phone
- 3096631326
- Fax
- 3096623551
- Primary Specialty
-
General Dentistry
1223G0001X
Other General Dentistry Providers in BLOOMINGTON, IL
| Name | Credential | NPI |
|---|---|---|
| DR. REX DALE MOORE | DDS | 1669468344 |
| DR. KEVIN KELSO SCHULTZ | DDS | 1427099167 |
| ERIC ABREU | D.D.S | 1750304655 |
| DR. NEZAR AHMED KASSEM | D.D.S. | 1700975653 |
| DAVID SCOTT HUME | D.D.S. | 1598835530 |
| DR. MARK BURGESS | DMD | 1154492593 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.