Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1972023117 Individual Practitioner Male Practitioner

Dr. Ethan Duewer , DMD

Dentist • Springfield, IL

Professional Overview & Biography Verified Profile Summary

Dr. Ethan Duewer, DMD is a registered healthcare professional specializing in Dentist in Springfield, IL. Practice services are available at 1140 RICKARD RD STE 1 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1140 Rickard Rd Ste 1

Springfield, IL 627046385

Telephone 2177873096
Associated Practice Facility / Clinic
🏢 Rickard Road Dental Group Facility NPI 1245981570

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Springfield, IL

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

Practicing in Springfield, 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: 2022-01-18
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License IL 019.031206

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 019.031206

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

1 Associated Practitioners
Dr. Shannon Cummins , DMD

Dentist - General Practice

NPI 1912190968

Doctor of Dental Medicine

Career & Practice History Timeline

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

14 Historical Events
📍
Updated Practice Location January 18, 2022

Registered at 1140 RICKARD RD STE 1, SPRINGFIELD, IL 627046385 (Tel: 2177873096)

📍
Updated Business Mailing Address January 18, 2022

Registered at 1140 RICKARD RD STE 1, SPRINGFIELD, IL 627046385

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 18, 2022

Dentist (License #019.031206 in IL)

NPI Profile Active February 12, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location February 12, 2018

Registered at 1440 W WALNUT ST, JACKSONVILLE, IL 626501143 (Tel: 2177882300)

📍
Updated Business Mailing Address February 12, 2018

Registered at 2239 E COOK ST, SPRINGFIELD, IL 627031944 (Tel: 2177882300)

👤
Provider Name / Credentials Updated February 12, 2018

Recorded as ETHAN DUEWER, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 12, 2018

Dentist (License #019.031206 in IL)

NPI Profile Active June 20, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location June 20, 2017

Registered at 1440 W WALNUT ST, JACKSONVILLE, IL 626501143 (Tel: 2177882300)

📍
Updated Business Mailing Address June 20, 2017

Registered at 2239 E COOK ST, SPRINGFIELD, IL 627031944 (Tel: 2177882300)

👤
Provider Name / Credentials Updated June 20, 2017

Recorded as ETHAN DUEWER, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 20, 2017

Dentist (License #019.031206 in IL)

🟢
Initial NPI Registration & Enumeration June 20, 2017

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: 1972023117
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 20, 2017
Last Update: January 18, 2022
Sole Proprietor: No

Mailing Address

1140 Rickard Rd Ste 1

Springfield, IL 627046385

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.