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LIBERTYVILLE PEDIATRIC DENTISTRY
NPI 1043088784
Clinic/Center - Dental in Libertyville, IL

Active since December 12, 2023
1870 W WINCHESTER RD STE 143, LIBERTYVILLE, IL 60048(630) 854-6044 Get Directions Write a Review

NPPES record last updated: December 12, 2023. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Libertyville Pediatric Dentistry NPPES

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

LIBERTYVILLE PEDIATRIC DENTISTRY (NPI 1043088784) is a healthcare organization registered as a dental in Libertyville, Illinois and active in the NPI registry since December 2023. The organization lists Bianca Hassoun, Operator, as its authorized official.

NPPES Registry Identity

NPI1043088784
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameLIBERTYVILLE PEDIATRIC DENTISTRY
Location Address1870 W WINCHESTER RD STE 143Libertyville, IL 60048-5359
Mailing Address1870 W Winchester Rd Ste 143Libertyville, IL 60048-5359 · (630) 854-6044
Phone(630) 854-6044
Organization SubpartNo
Authorized OfficialBianca HassounOperator · (630) 854-6044
Enumeration DateDecember 12, 2023
NPPES CertifiedDecember 12, 2023
✔ NPI 1043088784 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
1870 W WINCHESTER RD STE 143, Libertyville, IL 60048
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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 Libertyville Pediatric Dentistry's NPI number?

The NPI number for Libertyville Pediatric Dentistry is 1043088784. It was assigned to this organization in the NPPES registry on December 12, 2023.

Where is Libertyville Pediatric Dentistry located?

Libertyville Pediatric Dentistry is located at 1870 W Winchester Rd Ste 143, Libertyville, IL 60048. The listed phone number is (630) 854-6044.

What is Libertyville Pediatric Dentistry's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Libertyville Pediatric Dentistry was last updated on December 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.