SOUTH BEND CHILDRENS DENTISTRY PC
NPI 1366579005
Dentist - Pediatric Dentistry in South Bend, IN

Q: What is South Bend Childrens Dentistry PC's NPI number?

The NPI number for South Bend Childrens Dentistry PC is 1366579005. It was assigned to this organization in the NPPES registry on February 28, 2007.

Q: What is South Bend Childrens Dentistry PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

Active since February 28, 2007

103 S EDDY, SOUTH BEND, IN 46617(574) 288-4400 Get Directions Write a Review

NPPES record last updated: January 31, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About South Bend Childrens Dentistry Pc NPPES

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

SOUTH BEND CHILDRENS DENTISTRY PC (NPI 1366579005) is a healthcare organization registered as a pediatric dentistry in South Bend, Indiana and active in the NPI registry since February 2007. The organization lists Deanna O'neil, President South Bend Childrens Dent, as its authorized official.

NPPES Registry Identity

NPI1366579005

Entity TypeOrganization

Primary Taxonomy1223P0221X

Legal Business NameSOUTH BEND CHILDRENS DENTISTRY PC

Location Address103 S EDDYSouth Bend, IN 46617

Mailing Address103 S EddySouth Bend, IN 46617 · (574) 288-4400

Phone(574) 288-4400

Organization SubpartNo

Authorized OfficialDeanna O'neilPresident South Bend Childrens Dent · (574) 288-4400

Enumeration DateFebruary 28, 2007

Last NPPES UpdateJanuary 31, 2013

✔ NPI 1366579005 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.

103 S EDDY, South Bend, IN 46617

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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

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 South Bend Childrens Dentistry PC's NPI number?

The NPI number for South Bend Childrens Dentistry PC is 1366579005. It was assigned to this organization in the NPPES registry on February 28, 2007.

Where is South Bend Childrens Dentistry PC located?

South Bend Childrens Dentistry PC is located at 103 S Eddy, South Bend, IN 46617. The listed phone number is (574) 288-4400.

What is South Bend Childrens Dentistry PC'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 South Bend Childrens Dentistry PC was last updated on January 31, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.