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ILLINOIS VALLEY ENDODONTICS LLC NPI 1407031305


NPI Information

NPI: 1407031305
Provider Name: ILLINOIS VALLEY ENDODONTICS LLC

Doing Business As: LEE M. CERESA DDS

Classification: Dentist - 1223E0200X
Entity Type: Organization

Specialization: Endodontics

Address:
1601 4TH ST
PERU, IL
ZIP 61354
Phone: (815) 224-3636
Get Directions

ILLINOIS VALLEY ENDODONTICS LLC is an endodontics dentist in Peru, IL. The provider is the branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. ILLINOIS VALLEY ENDODONTICS LLC NPI is 1407031305. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Lee M. Ceresa Dds.

The provider's business location address is:

1601 4TH ST
PERU, IL
ZIP 61354-507
Phone: (815) 224-3636
Fax: (815) 220-1479

The provider's authorized official is Lee Michael Ceresa .
The authorized official title is Owner/dentist and has the following contact phone number (815) 224-3636.

The enumeration date for this NPI number is 1/9/2008 and was last updated on 1/9/2008.


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
11223E0200XDentistEndodonticsILLINOISYes

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

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