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ASSOCIATED PEDIATRIC DENTISTRY, LLC
NPI 1235527490
Dentist - Pediatric Dentistry in O Fallon, IL

Active since December 22, 2014
4945 STONE FALLS CTR, SUITE B, O FALLON, IL 62269(618) 622-0212 Get Directions Write a Review

NPPES record last updated: December 22, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Associated Pediatric Dentistry, Llc NPPES

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

ASSOCIATED PEDIATRIC DENTISTRY, LLC (NPI 1235527490) is a healthcare organization registered as a pediatric dentistry in O Fallon, Illinois and active in the NPI registry since December 2014. The organization lists Kevin C Beyersdorfer, Vice President, as its authorized official.

NPPES Registry Identity

NPI1235527490
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameASSOCIATED PEDIATRIC DENTISTRY, LLC
Location Address4945 STONE FALLS CTR, SUITE BO Fallon, IL 62269-7801
Mailing Address4945 Stone Falls Ctr, Suite BO Fallon, IL 62269-7801 · (618) 622-0212
Phone(618) 622-0212
Organization SubpartNo
Authorized OfficialKevin C BeyersdorferVice President · (618) 622-0212
Enumeration DateDecember 22, 2014
✔ NPI 1235527490 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.
4945 STONE FALLS CTR, O Fallon, IL 62269
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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 4

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

STONE FALLS DENTAL CARE, LLC
Dentist
4945 STONE FALLS CTR, SUITE A
O FALLON, IL 62269
St. Clair County (618) 624-2800
CARLEIGH PRANE DMD
Dentist (General Practice)
4945 STONE FALLS CTR, SUITE A
O FALLON, IL 62269
St. Clair County (618) 624-2800
GERUSA MELLO-ANDERSON D.D.S.
Dentist (Pediatric Dentistry)
4945 STONE FALLS CTR, SUITE B
O FALLON, IL 62269
St. Clair County (618) 622-0212
ASSOCIATED PEDIATRIC DENTISTRY LTD
Dentist (Pediatric Dentistry)
4945 STONE FALLS CTR, SUITE B
O FALLON, IL 62269
St. Clair County (618) 622-0212

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 Associated Pediatric Dentistry, LLC's NPI number?

The NPI number for Associated Pediatric Dentistry, LLC is 1235527490. It was assigned to this organization in the NPPES registry on December 22, 2014.

Where is Associated Pediatric Dentistry, LLC located?

Associated Pediatric Dentistry, LLC is located at 4945 Stone Falls Ctr Suite B, O Fallon, IL 62269. The listed phone number is (618) 622-0212.

What is Associated Pediatric Dentistry, LLC'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 Associated Pediatric Dentistry, LLC was last updated on December 22, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.