CITY KIDS DENTAL NORTH SHORE, LLC (NPI# 1629218557) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629218557 |
| Entity Type | Organization |
| Organization Name | CITY KIDS DENTAL NORTH SHORE, LLC |
| Practice Address |
585 Lincoln Ave Suite 2 Winnetka IL 60093-2351 |
| Practice Telephone | 8474460950 |
| Practice Fax Number | 8474460985 |
| Mailing Telephone | 8474460950 |
| Mailing Fax Number | 8474460985 |
| Enumeration Date | 2009-03-05 |
| Last Update Date | 2012-08-16 |
| Authorized Official Name | DR. A. MELISSA LOPEZ (CO-OWNER) |
| Authorized Official Telephone | 8474460950 |
| Authorized Official Credential | DMD, MPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
019025964 | IL | Dental Providers |
| Street Address |
585 LINCOLN AVE SUITE 2 |
| City | WINNETKA |
| State | IL |
| Zip Code | 60093-2351 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740390285 | Ana Melissa Lopez | Dentist | 585 Lincoln Ave, Winnetka, IL 60093-2351 | 2006-08-30 |
| 1477685071 | Ford Orthodontics Ltd | Dentist | 585 Lincoln Ave, Winnetka, IL 60093-2351 | 2007-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740812346 | Rosa Machabanski | Counselor | Josselyn Center, 405 Central Ave, Northfield, IL 60093 | 2020-02-11 |
| 1972080273 | Solutions-north Shore | Clinic/Center | 550 W Frontage Road, Suite 2810, Northfield, IL 60093 | 2018-07-19 |
| 1639671001 | Ilyssa Emily Lasky | Counselor | 723 Elm St Ste 20, Winnetka, IL 60093 | 2018-03-01 |
| 1285140079 | Rebecca Price | Social Worker | 400 Central Ave Ste 202, Northfield, IL 60093 | 2017-12-17 |
| 1063801033 | Anthony J. Geroulis, Md., S.c | Otolaryngology | 330 West Frontage Rd, Northfield, IL 60093 | 2015-01-14 |
| 1417354093 | Ardeshir Raghian Dds PC | Dentist | 723 Elm Street, Suite 21, Winnetka, IL 60093 | 2014-11-26 |
| 1811261092 | Jordan Allen Anderson | Specialist/Technologist | 7 Happ Road, New Trier Township High School, Northfield, IL 60093 | 2012-03-06 |
| 1326317801 | Anita Lynn Schmidt | Social Worker | 466 Central Ave Ste 50, Northfield, IL 60093 | 2011-12-29 |
| 1992087027 | Sivan Hannah Schondorf | Speech-Language Pathologist | 465 Central Ave., 201, Northfield, IL 60093 | 2011-09-14 |
| 1831409317 | The Arnold Center for Integrated Wellness, P.C. | Psychologist | 456 W. Frontage Rd., Suite 32, Northfield, IL 60093 | 2010-10-18 |
| Find all providers in zip 60093 | ||||
| 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 |
|---|---|---|---|---|
| 1992911408 | Poppy Widyastuti The | Dentist | 20800 Sherman Way, Winnetka, CA 91306-2707 | 2007-05-14 |
| 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.