PEDIATRIC DENTISTRY LTD (NPI# 1952454878) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952454878 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC DENTISTRY LTD |
| Practice Address |
860 Summit St Suite 246 Elgin IL 60120-5145 |
| Practice Telephone | 8476951693 |
| Practice Fax Number | 8476959212 |
| Mailing Telephone | 8476951693 |
| Mailing Fax Number | 8476959212 |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. DALE CHARLES NICKELSEN (PRESIDENT) |
| Authorized Official Telephone | 8476951693 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
IL | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487882718 | Pediatric Dentistry Ltd | Dentist | 1205 16th Ave. South, Fargo, ND 58103 | 2009-06-25 |
| 1619084084 | Pediatric Dentistry Ltd | Dentist | 1205 16th Ave South, Fargo, ND 58103 | 2006-08-23 |
| Street Address |
860 SUMMIT ST SUITE 246 |
| City | ELGIN |
| State | IL |
| Zip Code | 60120-5145 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801881156 | Scal Inc | Durable Medical Equipment & Medical Supplies | 860 Summit St, Elgin, IL 60120-5145 | 2005-09-13 |
| 1114296712 | Smiles of Elgin P.c | Dentist | 860 Summit St, Suite 134, Elgin, IL 60120-5145 | 2011-12-28 |
| 1265748149 | Dale Charles Nickelsen | Dentist | 860 Summit St, Ste 246, Elgin, IL 60120-5145 | 2010-08-30 |
| 1902051121 | Meghan Kathleen Whelan | Physician Assistant | 860 Summit St, Suite 123, Elgin, IL 60120 | 2008-12-02 |
| 1447421615 | Parin K Desai Dds, PC | Dentist | 860 Summit St, Suite 111, Elgin, IL 60120-5145 | 2008-03-17 |
| 1952583783 | V Susarla Mdsc | Family Medicine | 860 Summit St, Suite 123, Elgin, IL 60120-5145 | 2007-12-04 |
| 1457483547 | Aleksandra M Gwozdz | Dentist | 860 Summit St, #134, Elgin, IL 60120 | 2007-03-12 |
| 1528132933 | Thomas Pointner | Dentist | 860 Summit St, Suite 153, Elgin, IL 60120-5145 | 2006-11-17 |
| 1518976323 | Savitha Susarla | Family Medicine | 860 Summit St, Ste 123, Elgin, IL 60120-5145 | 2006-08-08 |
| 1922014315 | Viswanatham Susarla | Internal Medicine | 860 Summit St, Ste 123, Elgin, IL 60120-5145 | 2006-07-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003391749 | Kids Above All | Clinic/Center | United Methodist Church, 651 Lillie Street, Elgin, IL 60120 | 2018-09-28 |
| 1215483979 | Kelly Fetherling | Social Worker | 6912 S Main St., Elgin, IL 60120 | 2016-08-31 |
| 1164870457 | Peter Norton | Pharmacist | 1038 Summit Street, Elgin, IL 60120 | 2016-05-27 |
| 1417316373 | Beverly Brewster | Counselor | 675 Varsity Dr., Elgin, IL 60120 | 2016-02-19 |
| 1407194780 | Well Baby Care PC | Pediatrics | 1185-87 Dundee Avenue, Suite A-2, Elgin, IL 60120 | 2013-01-22 |
| 1740533546 | Vna Health Care | Clinic/Center | 801 Villa Street, Elgin, IL 60120 | 2012-10-18 |
| 1457638934 | Sharon Rose Nemenzo Araneta | Physical Therapist | 795 Summit St, Elgin, IL 60120 | 2011-11-10 |
| 1770866451 | Claudette M Vanhessen | Pharmacist | 815 Summit Street, Elgin, IL 60120 | 2011-09-20 |
| 1083993430 | Monica J. Fudala | Family Medicine | 820 Summit St # B4, Elgin, IL 60120 | 2011-08-16 |
| 1144517830 | Complete Care Medical Center, S.c | Family Medicine | 373 Summit St Ste 100, Elgin, IL 60120 | 2011-07-01 |
| Find all providers in zip 60120 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578009577 | Bryan R Blazer Dds PC | Clinic/Center | 431 Summit St Ste 105, Elgin, IL 60120-3861 | 2017-01-13 |
| 1699240416 | Elgin Dental Care, LLC | Clinic/Center | 431 Summit St Ste 105, Elgin, IL 60120-3861 | 2018-10-08 |
| 1295122539 | Mclean Dental Clinic, P.C. | Clinic/Center | 552 N Mclean Blvd, Elgin, IL 60123-3242 | 2015-04-24 |
| 1588083059 | Mahendra Tolia Dds | Clinic/Center | 417 Dundee Ave, Elgin, IL 60120-3830 | 2014-04-14 |
| 1851639835 | Airlte Dental of Elgin | Clinic/Center | 40 N Airlite St, Suite 1a, Elgin, IL 60123-4965 | 2013-01-24 |
| 1477801298 | Michael D. Johnson, D.d.s.,p.c. | Clinic/Center | 2090 Larkin Ave, Unit One-rear, Elgin, IL 60123-5845 | 2012-08-28 |
| 1891069183 | Steven Sirin Dds PC | Clinic/Center | 1 Crescent St, Elgin, IL 60123-6267 | 2012-03-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124629514 | Chicago Pediatric Dentistry and Orthodontics | Clinic/Center | 1136 S Delano Ct W Ste B202, Chicago, IL 60605-3734 | 2020-11-03 |
| 1437750031 | Secure Dental Xi | Clinic/Center | 1843 W Golf Rd, Schaumburg, IL 60194-1148 | 2020-11-02 |
| 1780283267 | Jenna Gaw, Dds, Pllc | Clinic/Center | 1724 Locust Pl Apt 303, Schaumburg, IL 60173-4239 | 2020-10-26 |
| 1740889344 | Nsp Dental LLC | Clinic/Center | 1900 Hollister Dr Ste 190, Libertyville, IL 60048-5283 | 2020-10-23 |
| 1285232827 | Paul Doodes Dds Phd PC | Clinic/Center | 45 S Park Blvd Ste 190, Glen Ellyn, IL 60137-6282 | 2020-10-15 |
| 1780290676 | Great Smile Dental Pllc | Clinic/Center | 720 Osterman Ave Ste 304, Deerfield, IL 60015-4339 | 2020-09-16 |
| 1669087375 | Naperville Smiles Dental | Clinic/Center | 8 W Gartner Rd Ste 124, Naperville, IL 60540-7549 | 2020-09-09 |
| 1649883364 | Mark J Maly Estate | Clinic/Center | 103 S Main St # Po, Orangeville, IL 61060-9244 | 2020-08-24 |
| 1760094718 | Stoffel and Tomazin Dental Associates, Ltd | Clinic/Center | 5718 W 35th St, Cicero, IL 60804-4222 | 2020-08-20 |
| 1215548771 | Meda Dental II LLC | Clinic/Center | 2735 Hassert Blvd Ste 159, Naperville, IL 60564-5205 | 2020-08-10 |
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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.