PEDIATRIC DENTAL SURGICAL ASSOCIATES PLLC
NPI 1013480755
Dentist - Pediatric Dentistry in Chicago, IL

Q: What is Pediatric Dental Surgical Associates PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

Active since January 04, 2019

2550 W ADDISON ST, CHICAGO, IL 60618(773) 423-6050 Get Directions Write a Review

NPPES record last updated: January 4, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Pediatric Dental Surgical Associates Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEDIATRIC DENTAL SURGICAL ASSOCIATES PLLC (NPI 1013480755) is a healthcare organization registered as a pediatric dentistry in Chicago, Illinois and active in the NPI registry since January 2019. The organization lists Johnny Kuttab, Ceo, as its authorized official.

NPPES Registry Identity

NPI1013480755

Entity TypeOrganization

Primary Taxonomy1223P0221X

Legal Business NamePEDIATRIC DENTAL SURGICAL ASSOCIATES PLLC

Location Address2550 W ADDISON STChicago, IL 60618-5952

Mailing Address2550 W Addison StChicago, IL 60618-5952 · (773) 423-6050

Phone(773) 423-6050

Organization SubpartNo

Authorized OfficialJohnny KuttabCeo · (773) 423-6050

Enumeration DateJanuary 4, 2019

✔ NPI 1013480755 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers

Taxonomy Code1223P0221X

Definition

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

2550 W ADDISON ST, Chicago, IL 60618

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAINE MERCEDES LEE NUNEZ NURSE PRACTITIONER

Nurse Practitioner

2550 W ADDISON ST
CHICAGO, IL 60618

Cook County (773) 281-2217

MONETT DIALYSIS LLC

Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)

2550 W ADDISON ST, SUITE A4
CHICAGO, IL 60618

Cook County (773) 281-2217

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pediatric Dental Surgical Associates PLLC's NPI number?

The NPI number for Pediatric Dental Surgical Associates PLLC is 1013480755. It was assigned to this organization in the NPPES registry on January 4, 2019.

Where is Pediatric Dental Surgical Associates PLLC located?

Pediatric Dental Surgical Associates PLLC is located at 2550 W Addison St, Chicago, IL 60618. The listed phone number is (773) 423-6050.

What is Pediatric Dental Surgical Associates PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Pediatric Dental Surgical Associates PLLC was last updated on January 4, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.