PERIODONTICS OF SOUTHERN ILLINOIS
NPI 1639224876
Dentist - Periodontics in Belleville, IL
- Organization
- Dentist
- Periodontics
About PERIODONTICS OF SOUTHERN ILLINOIS
This page provides the complete NPI Profile along with additional information for Periodontics Of Southern Illinois, a provider established in Belleville, Illinois operating as a Dentist, focusing in periodontics . The healthcare provider is registered in the NPI registry with number 1639224876 assigned on January 2007. The practitioner's primary taxonomy code is 1223P0300X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Dr. Josepj A Renner D.d.s. (Owner)
- NPI
- 1639224876 Verify this NPI
- Provider Name
- PERIODONTICS OF SOUTHERN ILLINOIS
- Entity Type
- Organization
- Location Address
- #11 PARK PLACE BELLEVILLE, IL 62226
- Location Phone
- (618) 233-7300
- Location Fax
- (618) 233-7432
- Mailing Address
- #11 PARK PLACE BELLEVILLE, IL 62226
- Mailing Phone
- (618) 233-7300
- Mailing Fax
- (618) 233-7432
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-25-2007
- Last Update Date
- 08-22-2020
- Code Navigator
A dentist like Periodontics Of Southern Illinois is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dentist Periodontics
- Taxonomy Code
- 1223P0300X
- Type
- Dental Providers
- License State
- IL
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 1223P0300X | Dental Providers | Dentist | (IL) |
| 2 | 1223P0300X | Dental Providers | Dentist | (IL) |
Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1639224876, enumerated as an "organization" on January 25, 2007.
The provider is located at #11 PARK PLACE BELLEVILLE, IL 62226 and the phone number is (618) 233-7300.
Dentist with taxonomy code 1223P0300X and a focus in Periodontics.
