MALCOLM PEDIATRIC DENTISTRY (NPI# 1538359427) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538359427 |
| Entity Type | Organization |
| Organization Name | MALCOLM PEDIATRIC DENTISTRY |
| Practice Address |
163 Cadillac Ct Suite 3 Belvidere IL 61008-1737 |
| Practice Telephone | 8155440909 |
| Practice Fax Number | 8155440922 |
| Mailing Telephone | 8155440909 |
| Mailing Fax Number | 8155440922 |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2007-07-27 |
| Authorized Official Name | DR. ANDY JOE MALCOLM (PEDIATRIC DENTIST) |
| Authorized Official Telephone | 8155440909 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Street Address |
163 CADILLAC CT SUITE 3 |
| City | BELVIDERE |
| State | IL |
| Zip Code | 61008-1737 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033207089 | Andy J Malcolm | Dentist | 163 Cadillac Ct, Suite 3, Belvidere, IL 61008-1737 | 2006-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902322944 | Lynsie Merry | Speech-Language Pathologist | 919 E. Sixth St., Belvidere, IL 61008 | 2017-08-22 |
| 1023379773 | Dylen Adair Larsen | Technician/Technologist | 521 South Street, Suite 1, Belvidere, IL 61008 | 2012-05-30 |
| 1376665224 | Ultrasound of Belvidere LLC | Radiologic Technologist | 1006 Logan Avenue, Belvidere, IL 61008 | 2007-04-04 |
| 1992845093 | Vicki Marie Harrison | Chiropractor | 301 North State Street, Belvidere, IL 61008 | 2007-02-07 |
| 1316007859 | Drs Drake Ltd | Dentist | 515 Pearl Street, Belvidere, IL 61008 | 2006-12-12 |
| 1194898015 | Family Optical Centre Inc | Optometrist | 304 No State St, Belvidere, IL 61008 | 2006-11-16 |
| 1457373946 | Mary Simmons | Family Medicine | 1700 Henry Luckow Ln, Belvidere, IL 61008 | 2006-07-24 |
| 1134172166 | Gabriel John Javurek | Chiropractor | 1800 Logan Ave, Belvidere, IL 61008 | 2006-05-19 |
| 1437642535 | Bailey A Bolwerk | Physical Therapist | 1731 Henry Luckow Ln, Belvidere, IL 61008 | 2018-06-13 |
| 1184079451 | Amanda L Ritter | Nurse Practitioner | 1700 Henry Luckow Ln, Belvidere, IL 61008 | 2016-04-25 |
| Find all providers in zip 61008 | ||||
| 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 |
|---|---|---|---|---|
| 1033207089 | Andy J Malcolm | Dentist | 163 Cadillac Ct, Suite 3, Belvidere, IL 61008-1737 | 2006-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932709433 | Children's Center for Dentistry | Dentist | 314 Susan Dr, Normal, IL 61761-6206 | 2020-10-26 |
| 1073125746 | Jessica Mattern Dds, Pllc | Dentist | 326 W Burlington Ave, La Grange, IL 60525-2363 | 2020-08-23 |
| 1568925014 | Southern Illinois Pediatric Dentistry of Edwardsville | Dentist | 1419 Lewis Road, Suite 2, Edwardsville, IL 62025 | 2019-04-11 |
| 1710450754 | Drs Selberg & Rice Pllc | Dentist | 4945 Stone Falls Ctr Ste B, O Fallon, IL 62269-7801 | 2019-01-02 |
| 1821583634 | Dentalgenix | Dentist | 113 E Schaumburg Rd, Schaumburg, IL 60194-3518 | 2018-06-25 |
| 1528562253 | Rachel Vorwaller | Dentist | 1460 N Halsted St Ste 403, Chicago, IL 60642-2607 | 2018-03-19 |
| 1942740006 | Dhwani M. Joshi | Dentist | 195 S Rand Rd Ste 110, Lake Zurich, IL 60047-2205 | 2017-03-08 |
| 1316393390 | Erin Marie Petrik | Dentist | 2530 N Clark St, Apt 203, Chicago, IL 60614-4972 | 2016-05-10 |
| 1669839593 | Algonquin Kids Dentistry, Inc | Dentist | 4097 W Algonquin Rd, Algonquin, IL 60102-9401 | 2016-01-22 |
| 1720468598 | Mehedia Haque | Dentist | 2062 N Milwaukee Ave, Chicago, IL 60647 | 2015-06-05 |
| Find all providers with the same taxonomy | ||||
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| 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.