PEBBLEWOOD DENTAL (NPI# 1760977078) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760977078 |
| Entity Type | Organization |
| Organization Name | PEBBLEWOOD DENTAL |
| Other Organization Name | PEBBLEWOOD DENTAL |
| Practice Address |
1550 N Route 59 Ste 148 Naperville IL 60563-0152 |
| Practice Telephone | (630) 369-6222 |
| Mailing Telephone | 6303696222 |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2018-06-28 |
| Authorized Official Name | DR. LARISSA NAVARRO (OWNER/DENTIST) |
| Authorized Official Telephone | 6303696222 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 019026759 | IL | Dental Providers |
| Other Name | Type Code |
|---|---|
| Pebblewood Dental | Doing Business As Name - Organization |
| Street Address |
1550 N ROUTE 59 STE 148 |
| City | NAPERVILLE |
| State | IL |
| Zip Code | 60563-0152 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902884 | Julia Ann Gottschalk | Nurse Practitioner | 1979 Mcdowell Rd, Unit 103, Naperville, IL 60563 | 2020-11-06 |
| 1700484847 | Lee Michael Harms I | Social Worker | 1952 Mcdowell Road, Suite 305, Naperville, IL 60563 | 2020-10-12 |
| 1881208478 | Poornima Swamy Gangaji | Dentist | 760 N, Illinois Rte 59, Ste100, Naperville, IL 60563 | 2020-09-01 |
| 1851901219 | Adiana Lebron | Social Worker | 2948 Artestian Road, Naperville, IL 60563 | 2020-07-31 |
| 1194342014 | Ingrid Lara | Behavioral Analyst | 1975 Mcdowell Rd #101, Naperville, IL 60563 | 2020-06-26 |
| 1396383030 | Jack Kelly | Assistant Behavior Analyst | 1975 Mcdowell Rd. #101, Naperville, IL 60563 | 2019-12-12 |
| 1316583529 | Arvind Ramakrishnan | Behavioral Analyst | 1975 Mcdowell Rd., Naperville, IL 60563 | 2019-11-22 |
| 1679115778 | Melissa Macias | Behavioral Analyst | 1975 Mcdowell Road, #101, Naperville, IL 60563 | 2019-10-10 |
| 1629619275 | Meghann Reid Vizintos | Physician Assistant | 1763 Freedom Dr Ste 117, Naperville, IL 60563 | 2019-10-04 |
| 1417413543 | Vikram Singh Cheema | Physician Assistant | 1335 North Mill Street, Naperville, IL 60563 | 2019-02-13 |
| Find all providers in zip 60563 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881208478 | Poornima Swamy Gangaji | Dentist | 760 N, Illinois Rte 59, Ste100, Naperville, IL 60563 | 2020-09-01 |
| 1972146470 | Bryan A Weyneth Dds PC | Dentist | 1100 Sherman Ave Ste 1031100, Naperville, IL 60563-8608 | 2019-10-28 |
| 1447892047 | Dental Group of Naperville, P.C. | Dentist | 1012 95th St Ste 5, Naperville, IL 60564-5040 | 2019-10-15 |
| 1396239877 | David Matthew Kurian | Dentist | 4023 Falcon Dr, Naperville, IL 60564-5884 | 2018-06-19 |
| 1184159550 | Chirag Ajay Parikh | Dentist | 4827 S Route 59, Ste. 115, Naperville, IL 60564-8318 | 2017-04-24 |
| 1427581065 | Mark J. Walsh | Dentist | 4s615 Karns Rd, Naperville, IL 60563-1508 | 2017-04-11 |
| 1407206238 | Hy Line Dental | Dentist | 1301 S Route 59 Ste 107, Naperville, IL 60564-9014 | 2016-06-13 |
| 1538574546 | Meredith Gantos | Dentist | 8 W Gartner Rd Ste 168, Naperville, IL 60540-7547 | 2014-06-27 |
| 1477968576 | Naper Dental Sleep Center, Ltd | Dentist | 300 E 5th Ave Ste 420, Naperville, IL 60563-3403 | 2014-06-26 |
| 1902236763 | Timothy Nugent | Dentist | 636 Raymond Dr Ste 102, Naperville, IL 60563-9790 | 2013-11-14 |
| Find all providers in NAPERVILLE | ||||
| City | NAPERVILLE |
| Zip Code | 60563 |
Please comment or provide details below to improve the information on PEBBLEWOOD DENTAL.
| 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.