PROFESSIONAL DENTAL ALLIANCE OF ILLINOIS SPECIALTY PLLC NPI 1558145227

NPI Information

NPI: 1558145227
Provider Name: PROFESSIONAL DENTAL ALLIANCE OF ILLINOIS SPECIALTY, PLLC

Doing Business As: ASSOCIATED DENTAL SPECIALISTS OF LONG GROVE

Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
4160 IL ROUTE 83 STE 308
LONG GROVE, IL
ZIP 60047
Phone: (847) 634-6166
Get Directions

PROFESSIONAL DENTAL ALLIANCE OF ILLINOIS SPECIALTY, PLLC is a pediatric dentistry dentist in Long Grove, 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. PROFESSIONAL DENTAL ALLIANCE OF ILLINOIS SPECIALTY, PLLC NPI is 1558145227. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Associated Dental Specialists Of Long Grove.

The provider's business location address is:

4160 IL ROUTE 83 STE 308
LONG GROVE, IL
ZIP 60047-034
Phone: (847) 634-6166

The provider's authorized official is Erica Quinteros .
The authorized official title is Credentialing and has the following contact phone number (724) 901-1964.

The enumeration date for this NPI number is 8/23/2023 and was last updated on 12/13/2023.

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	Primary
1	1223G0001X	Dentist	General Practice	No
2	1223X0400X	Dentist	Orthodontics and Dentofacial Orthopedics	No
3	1223P0221X	Dentist	Pediatric Dentistry	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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