PEDIATRIC DENTISTRY LTD NPI 1952454878

NPI Information

NPI: 1952454878
Provider Name: PEDIATRIC DENTISTRY LTD
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
860 SUMMIT ST
SUITE 246
ELGIN, IL
ZIP 60120
Phone: (847) 695-1693
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PEDIATRIC DENTISTRY LTD is a dental clinic center in Elgin, IL. PEDIATRIC DENTISTRY LTD NPI is 1952454878. The provider is registered as an organization entity type.

The provider's business location address is:

860 SUMMIT ST
SUITE 246
ELGIN, IL
ZIP 60120-145
Phone: (847) 695-1693
Fax: (847) 695-9212

The provider's authorized official is Dale Charles Nickelsen .
The authorized official title is President and has the following contact phone number (847) 695-1693.

The enumeration date for this NPI number is 1/22/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental		ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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