Dr Keri Lynn Sundberg, DDS - Medicare Dentist in Mendota, IL

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Dr Keri Lynn Sundberg, DDS is a medicare enrolled "Dentist - General Practice" provider in Mendota, Illinois. Her current practice location is West Side Family Dentistry, Ltd., 709 Plaza Drive, Mendota, Illinois. You can reach out to her office (for appointments etc.) via phone at (815) 539-7004.

Dr Keri Lynn Sundberg is licensed to practice in Illinois (license number 019025531) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1568536845.

Contact Information

Dr Keri Lynn Sundberg, DDS
West Side Family Dentistry, Ltd., 709 Plaza Drive,
Mendota, IL 61342
(815) 539-7004
(815) 539-7060

Map and Direction




Healthcare Provider's Profile

Full NameDr Keri Lynn Sundberg
GenderFemale
SpecialityDentist - General Practice
LocationWest Side Family Dentistry, Ltd., Mendota, Illinois
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1568536845
  • Provider Enumeration Date: 11/20/2006
  • Last Update Date: 10/05/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 6800819681
  • Enrollment ID: I20060109000147

Medical Identifiers

Medical identifiers for Dr Keri Lynn Sundberg such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1568536845NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1223G0001XDentist - General Practice 019025531 (Illinois)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Keri Lynn Sundberg allows following entities to bill medicare on her behalf.
Entity NameWest Side Family Dentistry Ltd
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1245617570
PECOS PAC ID: 5294757613
Enrollment ID: O20051229000347

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Keri Lynn Sundberg is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Keri Lynn Sundberg, DDS
709 Plaza Drive,
Mendota, IL 61342

Ph: (815) 539-7004		Dr Keri Lynn Sundberg, DDS
West Side Family Dentistry, Ltd., 709 Plaza Drive,
Mendota, IL 61342

Ph: (815) 539-7004

Reviews and Comments


Dentist in Mendota, IL

Dr. Kristen Marie Beversdorf, D.M.D.
Dentist
Medicare: Medicare Enrolled
Practice Location: 709 Plaza Dr, Mendota, IL 61342
Phone: 815-539-7004    
Dr. Ernesto Antonio Villalobos, DDS, MS
Dentist
Medicare: Medicare Enrolled
Practice Location: 1318 Meriden St, Mendota, IL 61342
Phone: 815-539-3000    
Dr. Peter Doran, DDS.
Dentist
Medicare: Not Enrolled in Medicare
Practice Location: 1318 Meriden St, Mendota, IL 61342
Phone: 815-539-3000    Fax: 815-539-3733
Dr. Jon C Krenz, DMD
Dentist
Medicare: Not Enrolled in Medicare
Practice Location: 704 Indiana Ave, Mendota, IL 61342
Phone: 815-538-5316    Fax: 815-539-7626

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.