Pediatric Dentisrty Specialists P.C.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

019023432 Issued in IL

Legal business name

PEDIATRIC DENTISRTY SPECIALISTS P.C.

Practice address

1103 Central Ave
Wilmette, IL 60091-2611

Phone

(847) 256-2501

Fax

(847) 256-2508

NPI assigned

Sep 12, 2012

Last updated

Sep 12, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Angela Kalb, D.D.S.NPI 1437365426

Title

Dentist

Phone

(847) 256-2501

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Angela J Kalb, D.D.S

  • Pediatric Dentistry
  • Wilmette, IL
  • NPI 1437365426
  NPD (past) Authorized official

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

{
    "created_epoch": "1347408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347408000000",
    "number": "1790035251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 CENTRAL AVE",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600912611",
            "telephone_number": "847-256-2501",
            "fax_number": "847-256-2508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 CENTRAL AVE",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600912611",
            "telephone_number": "847-256-2501",
            "fax_number": "847-256-2508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTISRTY SPECIALISTS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-12",
        "last_updated": "2012-09-12",
        "status": "A",
        "authorized_official_last_name": "KALB",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "847-256-2501",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": "019023432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shruti Patel, LCPC
• Path to Empowerment PLLC
• Patricia Nolan LCSW LLC
• Peak Therapeutics, LTD (Peak and Balance Centers of America)
• Joie Pecoraro, LSW
• Pediatric Eye Associates, PC (Pediatric Eye Associates)
• Jodi Petchenik, M.S.W., L.C.S.W.
• Peter R. Lewy, MD, LTD (Pediatric Associates of the North Shore)
• Nancy E Peter, MSW, LCSW
• Kathleen Philben, PH.D.

• Pediatric Dentistry in Wilmette, IL
• Providers in Wilmette, IL by specialty
• Pediatric Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; 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.