Kyle E Pedersen DDS PC

Primary specialty

DentistTaxonomy code 122300000X

License

021001694 Issued in IL

Legal business name

KYLE E PEDERSEN DDS PC

Doing business as

Dayspring Pediatric Dentistry

Practice address

2570 Foxfield Rd
Ste 203
St Charles, IL 60174-1406

Phone

(630) 587-4444

Fax

(630) 587-5811

NPI assigned

Oct 1, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kyle E Pedersen, DDS

Title

Owner

Phone

(630) 587-4444

Specialties & licenses 1

Addresses

Other names 1

• Dayspring Pediatric Dentistry Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299456000000",
    "number": "1760679005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2570 FOXFIELD RD",
            "address_2": "STE 203",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741406",
            "telephone_number": "630-587-4444",
            "fax_number": "630-587-5811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 FOXFIELD RD",
            "address_2": "STE 203",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741406",
            "telephone_number": "630-587-4444",
            "fax_number": "630-587-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KYLE E PEDERSEN DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-01",
        "last_updated": "2011-03-07",
        "status": "A",
        "authorized_official_last_name": "PEDERSEN",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-587-4444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "021001694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dayspring Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nancy Joanne Kuhn, L.M.F.T., L.C.P.C.
• Meghna Kumar
• Dave Kunik
• Andrew Kuplic
• Madeline Carol Kwiatkowski, DO
• Olena Kyrylenko, PMHNP
• Karyssa Frances Labayen
• Therese Marie Labuz
• Nicole Dorothea Lacava, APRN
• Jennifer Lynn Ladner

• Dentist in St Charles, IL
• Providers in St Charles, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.