Plainfield Pediatric Dental Care PC

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

019024754 Issued in IL

Legal business name

PLAINFIELD PEDIATRIC DENTAL CARE PC

Practice address

13621 S. RT 59
Unit 101
Plainfield, IL 60544

Phone

(815) 439-2400

NPI assigned

May 6, 2016

Last updated

May 6, 2016By 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. Vlad Ferdkoff, D.D.S.

Title

Owner

Phone

(847) 877-6858

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1462492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462492800000",
    "number": "1790131936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13621 S. RT 59",
            "address_2": "UNIT 101",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "60544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13621 S. RT 59",
            "address_2": "UNIT 101",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "60544",
            "telephone_number": "815-439-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLAINFIELD PEDIATRIC DENTAL CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-06",
        "last_updated": "2016-05-06",
        "status": "A",
        "authorized_official_last_name": "FERDKOFF",
        "authorized_official_first_name": "VLAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-877-6858",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "IL",
            "license": "019024754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Plainfield Family Clinic, LLC
• Plainfield Family Dental Center
• Plainfield Fire Protection District
• Plainfield Ophthalmology, M.D., S.C.
• Plainfield Ophthalmology, M.D., S.C.
• Plainfield School Dist 202
• Plainfield Supportive Living, LLC (Heritage Woods of Plainfield)
• Plainfield Surgery Center, LLC
• Platinum Pediatric Therapy, Inc.
• Kaitlyn Lea Platt

• Preferred Provider Organization in Plainfield, IL
• Providers in Plainfield, IL by specialty
• Preferred Provider Organization in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2016; 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.