CHICAGO PEDIATRIC DENTISTRY AND ORTHODONTICS (NPI# 1124629514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124629514 |
| Entity Type | Organization |
| Organization Name | CHICAGO PEDIATRIC DENTISTRY AND ORTHODONTICS |
| Practice Address |
1136 S Delano Ct W Ste B202 Chicago IL 60605-3734 |
| Practice Telephone | 3127660995 |
| Mailing Telephone | 3127660995 |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2020-11-03 |
| Authorized Official Name | DR. JUSTIN WELKE (OWNER) |
| Authorized Official Telephone | 6308861780 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities | ||
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Street Address |
1136 S DELANO CT W STE B202 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60605-3734 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568074219 | Kheri Dunkins | Counselor | 1136 S Delano Ct, Suite B201, Chicago, IL 60605 | 2020-08-22 |
| 1134739196 | Erin Odonnell | Physical Therapist | 1255 Soputh State Street, Unit 6, Chicago, IL 60605 | 2020-08-05 |
| 1225658032 | Rita Haber | Speech-Language Pathologist | 1255 S Michigan Avenue, 207, Chicago, IL 60605 | 2020-04-21 |
| 1285288753 | My Travel Guy, Inc. | Transportation Broker | 1300 S. Wabash Ave. Suite # 205, Chicago, IL 60605 | 2019-08-01 |
| 1699230417 | Iesha Marsh | Home Health Aide | 820 S Park Terrance, Apt813, Chicago, IL 60605 | 2019-02-06 |
| 1538633482 | Sara Miller | Counselor | 401 S. Lasalle St. Suite 800h, Chicago, IL 60605 | 2019-01-14 |
| 1992203798 | Lorna Johnson | Nurse Practitioner | 1740 W Taylor St., 764e Uih, Mc 509, Chicago, IL 60605 | 2018-01-26 |
| 1790226207 | Undine and Associates | Social Worker | 410 S. Michigan Ave, Ste 943, Chicago, IL 60605 | 2017-03-16 |
| 1659811529 | Paul Parpart | Occupational Therapist | 1235 S Prairie, Chicago, IL 60605 | 2017-02-27 |
| 1144679879 | Osco Drug | Ambulance | 1529 S State St 6e, Chicago, IL 60605 | 2016-06-03 |
| Find all providers in zip 60605 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| 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. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528562253 | Rachel Vorwaller | Dentist | 1460 N Halsted St Ste 403, Chicago, IL 60642-2607 | 2018-03-19 |
| 1316393390 | Erin Marie Petrik | Dentist | 2530 N Clark St, Apt 203, Chicago, IL 60614-4972 | 2016-05-10 |
| 1720468598 | Mehedia Haque | Dentist | 2062 N Milwaukee Ave, Chicago, IL 60647 | 2015-06-05 |
| 1811300437 | Michaella Radich Heitzler | Dentist | 1611 N. Wolcott Ave, Chicago, IL 60622 | 2014-06-11 |
| 1356768030 | Esther Levine Pincus | Dentist | Chicago Dental Professionals, 2340 North Clybourn Avenue, Chicago, IL 60614 | 2014-03-19 |
| 1316382187 | Serena Mitchual | Dentist | 801 S Paulina St Rm 256, Chicago, IL 60612-7210 | 2013-05-07 |
| 1962790428 | Megan Davenport | Dentist | 1611 N. Wolcott Ave., Chicago, IL 60622-1362 | 2011-07-19 |
| 1295968121 | Smile Lee Faces | Dentist | 4197 S Archer Ave, Chicago, IL 60632 | 2009-08-26 |
| 1013147024 | Yummy Dental | Dentist | 3500 N Lincoln Ave, Chicago, IL 60657-1104 | 2009-07-24 |
| 1659513950 | Melissa Marie Connell | Dentist | 1611 Wolcott Ave., Chicago, IL 60622 | 2009-04-01 |
| Find all providers in CHICAGO | ||||
Please comment or provide details below to improve the information on CHICAGO PEDIATRIC DENTISTRY AND ORTHODONTICS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.