Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1992919831 Individual Practitioner Male Practitioner

Dr. John Edward Halversen , DDS

Dentist • Rockford, IL

Professional Overview & Biography Verified Profile Summary

Dr. John Halversen, DDS is a registered healthcare professional specializing in Dentist in Rockford, IL. Practice services are available at 1200 W STATE ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1200 W State St

Rockford, IL 611022112

Telephone 8154901600
Fax 8154901881
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Rockford, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 12.1 Yrs
Regional Practice Density
72 Specialists

Practicing in Rockford, IL (4751 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

CMS Verified: 2025-08-26
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License IL 019021620

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Dentist - General Practice

NUCC Taxonomy Code: 1223G0001X

State License IL 019-021620

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

40 Associated Practitioners
Caryn Ruzic , APRN

Nurse Practitioner - Family

NPI 1003572660

Advanced Practice Registered Nurse

Dr. John Wall , MD

Family Medicine

NPI 1003899071

Doctor of Medicine (M.D.)

Dr. Adekola Ashaye , MD

Internal Medicine

NPI 1003899162

Doctor of Medicine (M.D.)

NPI 1013188408

Doctor of Medicine (M.D.)

NPI 1013363290

Licensed Social Worker

Dr. Cornita Cannon , MD

Obstetrics & Gynecology

NPI 1013595297

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

9 Historical Events
📍
Updated Practice Location August 26, 2025

Registered at 1200 W STATE ST, ROCKFORD, IL 611022112 (Tel: 8154901600)

📍
Updated Business Mailing Address August 26, 2025

Registered at 1200 W STATE ST, ROCKFORD, IL 611022112 (Tel: 8154901600)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 26, 2025

Dentist (License #019-021620 in IL)

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 1110 S MULFORD RD, ROCKFORD, IL 611084213 (Tel: 8153972200)

📍
Updated Business Mailing Address July 08, 2007

Registered at 1110 S MULFORD RD, ROCKFORD, IL 611084213 (Tel: 8153972200)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as JOHN HALVERSEN, D.D.S.

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

Dentist

🟢
Initial NPI Registration & Enumeration May 10, 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: 1992919831
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 10, 2007
Last Update: August 26, 2025
Sole Proprietor: Yes

Mailing Address

1200 W State St

Rockford, IL 611022112

Phone: 8154901600

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.