PLAINFIELD PEDIATRIC DENTAL CARE PC NPI 1790131936

NPI Information

  • NPI: 1790131936
  • Provider Name: PLAINFIELD PEDIATRIC DENTAL CARE PC
  • Classification: Preferred Provider Organization - 305R00000X
  • Entity Type: Organization
  • Address: 13621 S. RT 59
    UNIT 101
    PLAINFIELD, IL
    ZIP 60544
  • Phone: (815) 439-2400

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NPI Details

PLAINFIELD PEDIATRIC DENTAL CARE PC is a preferred provider organization in Plainfield, IL. The provider is a group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. PLAINFIELD PEDIATRIC DENTAL CARE PC NPI is 1790131936. The provider is registered as an organization entity type.

The provider's business location address is:

13621 S. RT 59
UNIT 101
PLAINFIELD, IL
ZIP 60544
Phone: (815) 439-2400

The provider's authorized official is Vlad Ferdkoff .
The authorized official title is Owner and has the following contact phone number (847) 877-6858.

The enumeration date for this NPI number is 5/6/2016 and was last updated on 5/6/2016.

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
1305R00000XPreferred Provider Organization019024754ILLINOISYes

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: 3/30/2025

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