Active NPI 1801937222 Individual Practitioner Male Practitioner

Gregory Marshall Randolph , D, DS

Dentist - General Practice • Bloomington, IL

Professional Overview & Biography Verified Profile Summary

Gregory Randolph, D, DS is a registered healthcare professional specializing in Dentist - General Practice in Bloomington, IL. Practice services are available at 119 N WILLIAMSBURG DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

119 N Williamsburg Dr

Bloomington, IL 617043528

Telephone 3096631326

Fax 3096623551

Associated Practice Facility / Clinic

🏢 Gregory M Randolph Dds & Associates, Ltd Facility NPI 1104639004

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Bloomington, IL

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 18.0 Yrs

Regional Practice Density

44 Specialists

Practicing in Bloomington, IL (5581 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License IL 019-020416

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Tax Identification Number

370958381 (IL)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners

Jack Morkin

Dentist

NPI 1639857162

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 03, 2025

Dentist (License #019-020416 in IL)

✅

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍

Updated Practice Location July 08, 2007

Registered at 119 N WILLIAMSBURG DR, BLOOMINGTON, IL 617043528 (Tel: 3096631326)

📍

Updated Business Mailing Address July 08, 2007

Registered at 119 N WILLIAMSBURG DR, BLOOMINGTON, IL 617043528 (Tel: 3096631326)

👤

Provider Name / Credentials Updated July 08, 2007

Recorded as GREGORY RANDOLPH, D,D.S.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist

🟢

Initial NPI Registration & Enumeration February 09, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1801937222

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: February 09, 2007

Last Update: April 03, 2025

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

119 N Williamsburg Dr

Bloomington, IL 617043528

Phone: 3096631326

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.