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CRYSTAL LAKE PEDIATRIC DENTAL LTD.
NPI 1043311681
Dentist - Pediatric Dentistry in Crystal Lake, IL

Active since September 26, 2006
820 E TERRA COTTA AVE, 111, CRYSTAL LAKE, IL 60014(815) 356-7960(815) 356-8051 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Crystal Lake Pediatric Dental Ltd. NPPES

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

CRYSTAL LAKE PEDIATRIC DENTAL LTD. (NPI 1043311681) is a healthcare organization registered as a pediatric dentistry in Crystal Lake, Illinois and active in the NPI registry since September 2006. The organization lists Anthony Louis Minutillo, President, as its authorized official.

NPPES Registry Identity

NPI1043311681
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameCRYSTAL LAKE PEDIATRIC DENTAL LTD.
Location Address820 E TERRA COTTA AVE, 111Crystal Lake, IL 60014-3649
Mailing Address820 E Terra Cotta Ave, 111Crystal Lake, IL 60014-3649 · (815) 356-7960 · Fax (815) 356-8051
Phone(815) 356-7960
Fax(815) 356-8051
Organization SubpartNo
Authorized OfficialAnthony Louis MinutilloPresident · (815) 356-7960
Enumeration DateSeptember 26, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1043311681 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.
820 E TERRA COTTA AVE, Crystal Lake, IL 60014
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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 20

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

OPEN ADVANCED MRI OF CRYSTAL LAKE, LLC
Radiology (Diagnostic Radiology)
820 E TERRA COTTA AVE, SUITE 136
CRYSTAL LAKE, IL 60014
McHenry County (815) 444-1330
SELECT PHYSICAL THERAPY OF ILLINOIS LIMITED PARTNERSHIP
Clinic/Center (Physical Therapy)
820 E TERRA COTTA AVE, STE 102
CRYSTAL LAKE, IL 60014
McHenry County (815) 455-3262
DR. BARRY A ALTSHULER MD
Pediatrics
820 E TERRA COTTA AVE, SUITE 226
CRYSTAL LAKE, IL 60014
McHenry County (815) 455-2100
DR. MARK JOSEPH MCKIM D.C.
Chiropractor
820 E TERRA COTTA AVE, STE 141
CRYSTAL LAKE, IL 60014
McHenry County (815) 477-7718
JAMES P GRIMM LCPC
Counselor (Professional)
820 E TERRA COTTA AVE, SUITE 215
CRYSTAL LAKE, IL 60014
McHenry County (847) 913-0393
DR. MELISSA REA KOWASZ-MCKIM D.C.
Chiropractor
820 E TERRA COTTA AVE, STE 141
CRYSTAL LAKE, IL 60014
McHenry County (815) 477-7718
MR. JALALUDDIN KHIMANI D.D.S.
Dentist (General Practice)
820 E TERRA COTTA AVE, SUITE 203
CRYSTAL LAKE, IL 60014
McHenry County (815) 444-1549
NATURE'S BALANCE ACUPUNCTURE
Acupuncturist
820 E TERRA COTTA AVE, SUITE 101
CRYSTAL LAKE, IL 60014
McHenry County (815) 788-8383

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 Crystal Lake Pediatric Dental Ltd.'s NPI number?

The NPI number for Crystal Lake Pediatric Dental Ltd. is 1043311681. It was assigned to this organization in the NPPES registry on September 26, 2006.

Where is Crystal Lake Pediatric Dental Ltd. located?

Crystal Lake Pediatric Dental Ltd. is located at 820 E Terra Cotta Ave 111, Crystal Lake, IL 60014. The listed phone number is (815) 356-7960.

What is Crystal Lake Pediatric Dental Ltd.'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 Crystal Lake Pediatric Dental Ltd. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.