PEDIATRIC DENTAL ASSOCIATES, PC (NPI# 1568709988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568709988 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC DENTAL ASSOCIATES, PC |
| Practice Address |
690 N Il Route 31 Suite D Crystal Lake IL 60012-3790 |
| Practice Telephone | 8154592727 |
| Practice Fax Number | 8154795723 |
| Mailing Telephone | 8154592727 |
| Mailing Fax Number | 8154795723 |
| Enumeration Date | 2013-01-04 |
| Last Update Date | 2013-01-04 |
| Authorized Official Name | DR. GEORGE LIN (PEDIATRIC DENTAL) |
| Authorized Official Telephone | 8154592727 |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225201460 | Pediatric Dental Associates, PC | Dentist | 2132 Ocean Ave, Brooklyn, NY 11229-1406 | 2008-04-09 |
| Street Address |
690 N IL ROUTE 31 SUITE D |
| City | CRYSTAL LAKE |
| State | IL |
| Zip Code | 60012-3790 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730197468 | Crystal Lake Oral Maxillofacial Surgery Ltd | Dentist | 690 N Il Route 31, Crystal Lake, IL 60012-3790 | 2006-08-05 |
| 1053603365 | Candace Marie Opon | Dentist | 690 N Il Route 31, Crystal Lake, IL 60012-3790 | 2011-05-04 |
| 1720150097 | Dennis James Mcdowell | Dentist | 690 N Il Route 31, Suite E, Crystal Lake, IL 60012-3790 | 2006-11-14 |
| 1871662486 | Frazier & Kopp Dds PC | Dentist | 690 N Il Route 31, Crystal Lake, IL 60012-3790 | 2006-11-07 |
| 1528144607 | Thomas Arthur Kopp | Dentist | 690 N Il Route 31, Crystal Lake, IL 60012-3790 | 2006-10-31 |
| 1063526796 | Fred M Fitzpatrick | Dentist | 690 N Il Route 31, Crystal Lake, IL 60012-3790 | 2006-08-19 |
| 1700990447 | Frederick M. Fitzpatrick, D.d.s., P.C. | Dentist | 690 N Il Route 31, Crystal Lake, IL 60012-3790 | 2006-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033574629 | Joan M Ryan | Counselor | 610 N Route 31, Suite E, Crystal Lake, IL 60012 | 2015-12-23 |
| 1285972331 | Lauren Elyse Westerman | Physical Therapist | 1000 Brighton Ln, Crystal Lake, IL 60012 | 2013-01-24 |
| 1447537469 | Sean Gale | Pharmacist | 135 Carmella Dr, Crystal Lake, IL 60012 | 2011-11-04 |
| 1477836625 | Judy Meekyung Fakhouri | Pharmacist | 315 N. Route 31, Crystal Lake, IL 60012 | 2011-09-23 |
| 1730462136 | Leslie Dawn Weckerlin | Pharmacist | 315 N Route 31, Crystal Lake, IL 60012 | 2011-09-21 |
| 1639452188 | Laura Jean Galles | Pharmacist | 315 N. Routet 31, Crystal Lake, IL 60012 | 2011-09-21 |
| 1326320516 | Stacey Jean Knuth | Pharmacist | 315 North Route 31, Crystal Lake, IL 60012 | 2011-09-13 |
| 1356469803 | Donn Orien Humphries | Chiropractor | 690 N Route 31, Suite F, Crystal Lake, IL 60012 | 2007-03-26 |
| 1538204508 | Midwest Physical Therapy Ctr | Clinic/Center | 630 N Rt 31, Suite 103, Crystal Lake, IL 60012 | 2007-02-20 |
| 1356488415 | Charlotte Joy Parcels | Social Worker | 8600 Route 14, Suite 110, Crystal Lake, IL 60012 | 2007-01-30 |
| Find all providers in zip 60012 | ||||
| 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 |
|---|---|---|---|---|
| 1073956017 | Kathleen A. Schroeder Dds | Dentist | 278 Memorial Dr, Crystal Lake, IL 60014-6246 | 2013-04-09 |
| 1053657809 | First Smiles Dental, PC | Dentist | 278 Memorial Dr, Suite B, Crystal Lake, IL 60014-6246 | 2012-12-26 |
| 1427212018 | Tony Louis Minutillo | Dentist | 820 E Terra Cotta Ave, Suite 111, Crystal Lake, IL 60014-3649 | 2008-07-14 |
| 1245450113 | Scott D Goldman | Dentist | 278 Memorial Dr, Crystal Lake, IL 60014-6246 | 2007-04-26 |
| 1043311681 | Crystal Lake Pediatric Dental Ltd. | Dentist | 820 E Terra Cotta Ave, 111, Crystal Lake, IL 60014-3649 | 2006-09-26 |
| 1063526796 | Fred M Fitzpatrick | Dentist | 690 N Il Route 31, Crystal Lake, IL 60012-3790 | 2006-08-19 |
| 1700990447 | Frederick M. Fitzpatrick, D.d.s., P.C. | Dentist | 690 N Il Route 31, Crystal Lake, IL 60012-3790 | 2006-08-19 |
| 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 | ||||
| City | CRYSTAL LAKE |
| Zip Code | 60012 |
Please comment or provide details below to improve the information on PEDIATRIC DENTAL ASSOCIATES, PC.
| 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.