Pediatric Dental Specialty Associates LTD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

PEDIATRIC DENTAL SPECIALTY ASSOCIATES LTD

Practice address

315 Alana Dr
New Lenox, IL 60451-1766

Phone

(815) 462-3030

Fax

(815) 462-4742

NPI assigned

Dec 5, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Genearnd C Algenio, DDS

Title

President

Phone

(815) 462-3030

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Generand Carandang Algenio, DDS, MS

  • Pediatric Dentistry
  • New Lenox, IL
  • NPI 1164820544
  NPD

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649721600000",
    "number": "1992863500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 ALANA DR",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604511766",
            "telephone_number": "815-462-3030",
            "fax_number": "815-462-4742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 ALANA DR",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604511766",
            "telephone_number": "815-462-3030",
            "fax_number": "815-462-4742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTAL SPECIALTY ASSOCIATES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A",
        "authorized_official_last_name": "ALGENIO",
        "authorized_official_first_name": "GENEARND",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-462-3030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha E Pastorik
• Patrick Omalley Bcba Inc
• Christine D Patterson, PHARM D
• Julie Rene Paul, APN
• Jessica L Pecho, PA-C
• Sean Pedley, DNP
• Jose Antonio Penaherrera, M.D.
• Mia Y Perri
• Eric Jon Petecki, O.D.
• Tecya Peterson, LSW

• Pediatric Dentistry in New Lenox, IL
• Providers in New Lenox, IL by specialty
• Pediatric Dentistry in Illinois

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