Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1053565218 Individual Practitioner Male Practitioner

Dr. Brian C Back , DMD

Dentist - General Practice • Mascoutah, IL

Professional Overview & Biography Verified Profile Summary

Dr. Brian Back, DMD is a registered healthcare professional specializing in Dentist - General Practice in Mascoutah, IL. Practice services are available at 104 E MAIN ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

104 E Main St

Mascoutah, IL 622582135

Telephone 6185667384
Fax 6185664290
Associated Practice Facility / Clinic
🏢 Taube Family Dental Facility NPI 1073968509

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Mascoutah, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.0 Yrs
Regional Practice Density
1 Specialists

Practicing in Mascoutah, 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 019027792

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.

Practice Associates & Co-Workers

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

2 Associated Practitioners
NPI 1376683193

Doctor of Dental Medicine

NPI 1891043451

Doctor of Dental Medicine

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active June 01, 2011

NPI status registered as active in NPPES database

📍
Updated Practice Location June 01, 2011

Registered at 104 E MAIN ST, MASCOUTAH, IL 622582135 (Tel: 6185667384)

📍
Updated Business Mailing Address June 01, 2011

Registered at 104 E MAIN ST, P.O. BOX 142, MASCOUTAH, IL 622582135 (Tel: 6185667384)

👤
Provider Name / Credentials Updated June 01, 2011

Recorded as BRIAN BACK, D.M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 01, 2011

Dentist (License #019027792 in IL)

🟢
Initial NPI Registration & Enumeration November 13, 2008

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: 1053565218
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 13, 2008
Last Update: June 01, 2011
Sole Proprietor: Yes

Mailing Address

104 E Main St, P.o. Box 142

Mascoutah, IL 622582135

Phone: 6185667384

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.