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PEDIATRIC DENTISTRY OF NORTHERN ILLINOIS LTD
NPI 1376651679
Dentist - Pediatric Dentistry in Rockford, IL

Active since August 27, 2006
4903 E STATE ST, ROCKFORD, IL 61108(815) 398-2323(815) 398-2328 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Pediatric Dentistry Of Northern Illinois Ltd NPPES

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

PEDIATRIC DENTISTRY OF NORTHERN ILLINOIS LTD (NPI 1376651679) is a healthcare organization registered as a pediatric dentistry in Rockford, Illinois and active in the NPI registry since August 2006. The organization lists Jeffrey James Johnson, Pediatric Dentist Owner President, as its authorized official.

NPPES Registry Identity

NPI1376651679
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NamePEDIATRIC DENTISTRY OF NORTHERN ILLINOIS LTD
Location Address4903 E STATE STRockford, IL 61108
Mailing Address4903 E State StRockford, IL 61108 · (815) 398-2323 · Fax (815) 398-2328
Phone(815) 398-2323
Fax(815) 398-2328
Organization SubpartNo
Authorized OfficialJeffrey James JohnsonPediatric Dentist Owner President · (815) 398-2323
Enumeration DateAugust 27, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1376651679 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in IL · 019
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.
4903 E STATE ST, Rockford, IL 61108
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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 MULTIPLE 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.

DR. JEFFREY JAMES JOHNSON D.D.S.
Dentist (Pediatric Dentistry)
4903 E STATE ST
ROCKFORD, IL 61108
Winnebago County (815) 398-2323
DR. JACOB CAINE DACHMAN DMD
Dentist (Pediatric Dentistry)
4903 E STATE ST
ROCKFORD, IL 61108
Winnebago County (815) 398-2323

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 Pediatric Dentistry Of Northern Illinois Ltd's NPI number?

The NPI number for Pediatric Dentistry Of Northern Illinois Ltd is 1376651679. It was assigned to this organization in the NPPES registry on August 27, 2006.

Where is Pediatric Dentistry Of Northern Illinois Ltd located?

Pediatric Dentistry Of Northern Illinois Ltd is located at 4903 E State St, Rockford, IL 61108. The listed phone number is (815) 398-2323.

What is Pediatric Dentistry Of Northern Illinois 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 Pediatric Dentistry Of Northern Illinois 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.