JERRY E UDELSON DDS PC NPI 1881885127

NPI Information

  • NPI: 1881885127
  • Provider Name: JERRY E UDELSON, DDS, PC
  • Classification: Dentist - 1223P0221X
  • Specialization: Pediatric Dentistry
  • Entity Type: Organization
  • Doing Business As: LITTLE TEETH BIG SMILES & CHILDREN'S DENTISTRY
  • PECOS Registration: Yes
  • Address: 1125 HARLEM AVE
    FOREST PARK, IL
    ZIP 60130
  • Phone: (708) 386-5437

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NPI Details

JERRY E UDELSON, DDS, PC is a pediatric dentistry dentist in Forest Park, 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. JERRY E UDELSON, DDS, PC NPI is 1881885127. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Little Teeth Big Smiles & Children's Dentistry.

The provider's business location address is:

1125 HARLEM AVE
FOREST PARK, IL
ZIP 60130-337
Phone: (708) 386-5437
Fax: (708) 771-5439

The provider's authorized official is Jerry E Udelson .
The authorized official title is President and has the following contact phone number (708) 386-5437.

The NPI 1881885127 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 8/1/2007 and was last updated on 7/17/2024.

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
11223P0221XDentistPediatric Dentistry021001495ILLINOISYes

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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