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PERIODONTICS OF SOUTHERN ILLINOIS
NPI 1639224876
Dentist - Periodontics in Belleville, IL

Active since January 25, 2007
#11 PARK PLACE, BELLEVILLE, IL 62226(618) 233-7300(618) 233-7432 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Periodontics Of Southern Illinois NPPES

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

PERIODONTICS OF SOUTHERN ILLINOIS (NPI 1639224876) is a healthcare organization registered as a periodontics in Belleville, Illinois and active in the NPI registry since January 2007. The organization lists Josepj A Renner, Owner, as its authorized official.

NPPES Registry Identity

NPI1639224876
Entity TypeOrganization
Primary Taxonomy1223P0300X
Legal Business NamePERIODONTICS OF SOUTHERN ILLINOIS
Location Address#11 PARK PLACEBelleville, IL 62226-2925
Mailing Address#11 Park PlaceBelleville, IL 62226-2925 · (618) 233-7300 · Fax (618) 233-7432
Phone(618) 233-7300
Fax(618) 233-7432
Organization SubpartNo
Authorized OfficialJosepj A RennerOwner · (618) 233-7300
Enumeration DateJanuary 25, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1639224876 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

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

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 Periodontics Of Southern Illinois's NPI number?

The NPI number for Periodontics Of Southern Illinois is 1639224876. It was assigned to this organization in the NPPES registry on January 25, 2007.

Where is Periodontics Of Southern Illinois located?

Periodontics Of Southern Illinois is located at #11 Park Place, Belleville, IL 62226. The listed phone number is (618) 233-7300.

What is Periodontics Of Southern Illinois's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

When was this NPI record last updated?

The NPPES record for Periodontics Of Southern Illinois 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.