FAIRVIEW HEIGHTS DENTISTRY
NPI 1811558208
Dentist in Fairview Heights, IL

Active since June 26, 2019
6407 N ILLINOIS ST, FAIRVIEW HEIGHTS, IL 62208(618) 310-0263(618) 212-9054 Get Directions Write a Review

NPPES record last updated: March 8, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Fairview Heights Dentistry NPPES

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

FAIRVIEW HEIGHTS DENTISTRY (NPI 1811558208) is a healthcare organization registered as a dentist in Fairview Heights, Illinois and active in the NPI registry since June 2019. The organization lists Bryan K Watanabe, Owner, as its authorized official.

NPPES Registry Identity

NPI1811558208
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NameFAIRVIEW HEIGHTS DENTISTRY, PLLC
Location Address6407 N ILLINOIS STFairview Heights, IL 62208-2720
Mailing AddressPo Box 920050Dallas, TX 75392-0050 · (714) 845-8500 · Fax (303) 952-0892
Fax(618) 212-9054
Organization SubpartNo
Authorized OfficialBryan K WatanabeOwner · (618) 310-0263
Enumeration DateJune 26, 2019
Last NPPES UpdateMarch 8, 2022
NPPES CertifiedMarch 8, 2022
NPI 1811558208 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

6407 N ILLINOIS ST, Fairview Heights, IL 62208

Other Names 1

Doing Business AsFairview Heights Dentistry

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist
6407 N ILLINOIS ST
FAIRVIEW HEIGHTS, IL 62208
Optometrist
6407 N ILLINOIS ST
FAIRVIEW HEIGHTS, IL 62208
Optometrist
6407 N ILLINOIS ST
FAIRVIEW HEIGHTS, IL 62208

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 Fairview Heights Dentistry, PLLC's NPI number?

The NPI number for Fairview Heights Dentistry, PLLC is 1811558208. It was assigned to this organization in the NPPES registry on June 26, 2019. The provider is doing business as Fairview Heights Dentistry.

Where is Fairview Heights Dentistry, PLLC located?

Fairview Heights Dentistry, PLLC is located at 6407 N Illinois St, Fairview Heights, IL 62208. The listed phone number is (618) 310-0263.

What is Fairview Heights Dentistry, PLLC's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for Fairview Heights Dentistry, PLLC was last updated on March 8, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.