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COLLINSVILLE PEDIATRIC DENTISTRY PLLC
NPI 1295366896
Dentist - Pediatric Dentistry in Collinsville, IL

Active since February 01, 2020
90 CRESTMOOR ST, COLLINSVILLE, IL 62234(618) 346-8000 Get Directions Write a Review

NPPES record last updated: February 1, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Collinsville Pediatric Dentistry Pllc NPPES

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

COLLINSVILLE PEDIATRIC DENTISTRY PLLC (NPI 1295366896), doing business as Gateway Little Smiles, is a healthcare organization registered as a pediatric dentistry in Collinsville, Illinois and active in the NPI registry since February 2020. The organization lists Corey Hastings, Owner/dentist, as its authorized official.

NPPES Registry Identity

NPI1295366896
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameCOLLINSVILLE PEDIATRIC DENTISTRY PLLC
Location Address90 CRESTMOOR STCollinsville, IL 62234-4951
Mailing Address90 Crestmoor StCollinsville, IL 62234-4951 · (618) 346-8000
Phone(618) 346-8000
Organization SubpartNo
Authorized OfficialCorey HastingsOwner/dentist · (618) 346-8000
Enumeration DateFebruary 1, 2020
✔ NPI 1295366896 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.
90 CRESTMOOR ST, Collinsville, IL 62234
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Other Names 1

Doing Business AsGateway Little Smiles

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.

KENNETH S. KOLLMANN, D.M.D.,P.C.
Dentist (Pediatric Dentistry)
90 CRESTMOOR ST, SPRING MEADOW PROFESSIONAL PARK
COLLINSVILLE, IL 62234
Madison County (618) 346-8000
DR. KENNETH SCOTT KOLLMANN D.M.D.
Dentist (Pediatric Dentistry)
90 CRESTMOOR ST, SPRING MEADOW PROFESSIONAL PARK
COLLINSVILLE, IL 62234
Madison County (618) 346-8000

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 Collinsville Pediatric Dentistry PLLC's NPI number?

The NPI number for Collinsville Pediatric Dentistry PLLC is 1295366896. It was assigned to this organization in the NPPES registry on February 1, 2020. The provider is doing business as Gateway Little Smiles.

Where is Collinsville Pediatric Dentistry PLLC located?

Collinsville Pediatric Dentistry PLLC is located at 90 Crestmoor St, Collinsville, IL 62234. The listed phone number is (618) 346-8000.

What is Collinsville Pediatric Dentistry 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 Collinsville Pediatric Dentistry PLLC was last updated on February 1, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.