NPIMap

Organization Active NPI

Pebblewood Dental

  • Dentist
  • Naperville, IL
National Provider Identifier
1760977078
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019026759 Issued in IL
Legal business name
PEBBLEWOOD DENTAL
Doing business as
Pebblewood Dental
Practice address
1550 N Route 59 Ste 148
Naperville, IL 60563-0152
Phone
(630) 369-6222
NPI assigned
Jun 28, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Larissa Navarro, DDSNPI 1821158940
Title
Owner/Dentist
Phone
(630) 369-6222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 019026759 IL Primary

Addresses

Primary practice location

1550 N Route 59 Ste 148
Naperville, IL 60563-0152

Mailing address

1550 N Route 59 Ste 148
Naperville, IL 60563-0152
Phone (630) 369-6222

Other names 1

  • Pebblewood Dental Doing business as

National Provider Directory

National Provider Directory

Locations

1550 N Route 59
Ste 148
Naperville, IL 60563
Phone (630) 369-6222

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1530144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1760977078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 N ROUTE 59 STE 148",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605630152",
            "telephone_number": "630-369-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 N ROUTE 59 STE 148",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605630152",
            "telephone_number": "630-369-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEBBLEWOOD DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-28",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "NAVARRO",
        "authorized_official_first_name": "LARISSA",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "630-369-6222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019026759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pebblewood Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.