CHILDREN'S CENTER FOR DENTISTRY PLLC NPI 1285184259

NPI Information

NPI: 1285184259
Provider Name: CHILDREN'S CENTER FOR DENTISTRY PLLC
Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
314 SUSAN DRIVE
NORMAL, IL
ZIP 61761
Phone: (309) 827-5437
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CHILDREN'S CENTER FOR DENTISTRY PLLC is a pediatric dentistry dentist in Normal, IL. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. CHILDREN'S CENTER FOR DENTISTRY PLLC NPI is 1285184259. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

314 SUSAN DRIVE
NORMAL, IL
ZIP 61761
Phone: (309) 827-5437
Fax: (309) 265-0288

The provider's authorized official is Gregory M Dietz .
The authorized official title is Owner & Provider and has the following contact phone number (309) 827-5437.

The enumeration date for this NPI number is 10/13/2016 and was last updated on 5/28/2021.

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	1223G0001X	Dentist	General Practice	019027386	ILLINOIS	No
2	1223G0001X	Dentist	General Practice			No
3	1223P0221X	Dentist	Pediatric Dentistry	021002544	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: 11/14/2023

NPI Synchronization or Removal

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