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WEST SIDE FAMILY DENTISTRY, LTD
NPI 1245617570
Dentist - General Practice in Mendota, IL

Active since May 06, 2015
709 PLAZA DR, MENDOTA, IL 61342(815) 539-7004(815) 539-7060 Get Directions Write a Review

NPPES record last updated: October 5, 2022. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About West Side Family Dentistry, Ltd NPPES

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

WEST SIDE FAMILY DENTISTRY, LTD (NPI 1245617570) is a healthcare organization registered as a general practice in Mendota, Illinois and active in the NPI registry since May 2015. The organization lists Keri Lynn Sundberg, Dentist/president, as its authorized official.

NPPES Registry Identity

NPI1245617570
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameWEST SIDE FAMILY DENTISTRY, LTD
Location Address709 PLAZA DRMendota, IL 61342-2457
Mailing Address709 Plaza DrMendota, IL 61342-2457 · (815) 539-7004 · Fax (815) 539-7060
Phone(815) 539-7004
Fax(815) 539-7060
Organization SubpartNo
Authorized OfficialKeri Lynn SundbergDentist/president · (815) 539-7004
Enumeration DateMay 6, 2015
Last NPPES UpdateOctober 5, 2022
NPPES CertifiedOctober 5, 2022
✔ NPI 1245617570 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in IL · 019-025531
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
709 PLAZA DR, Mendota, IL 61342
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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

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

DR. KRISTEN MARIE BEVERSDORF D.M.D.
Dentist (General Practice)
709 PLAZA DR
MENDOTA, IL 61342
Lasalle County (815) 539-7004

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 West Side Family Dentistry, Ltd's NPI number?

The NPI number for West Side Family Dentistry, Ltd is 1245617570. It was assigned to this organization in the NPPES registry on May 6, 2015.

Where is West Side Family Dentistry, Ltd located?

West Side Family Dentistry, Ltd is located at 709 Plaza Dr, Mendota, IL 61342. The listed phone number is (815) 539-7004.

What is West Side Family Dentistry, Ltd's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for West Side Family Dentistry, Ltd was last updated on October 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.