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SOUTHWEST PEDIATRIC DENTAL
NPI 1982433819
Dentist - Pediatric Dentistry in St. John, IN

Active since July 30, 2024
8217 WICKER AVE, ST. JOHN, IN 46373(219) 440-1710 Get Directions Write a Review

NPPES record last updated: October 3, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 3, 2024, Jul 30, 2024 (2 updates tracked since 2024).

About Southwest Pediatric Dental NPPES

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

SOUTHWEST PEDIATRIC DENTAL (NPI 1982433819) is a healthcare organization registered as a pediatric dentistry in St. John, Indiana and active in the NPI registry since July 2024. The organization lists James R Mitsos, Owner, as its authorized official.

NPPES Registry Identity

NPI1982433819
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameNORTHWEST PEDIATRIC DENTAL LLC
Location Address8217 WICKER AVESt. John, IN 46373
Mailing Address8217 Wicker AveSt. John, IN 46373 · (219) 440-1710
Phone(219) 440-1710
Organization SubpartNo
Authorized OfficialJames R MitsosOwner · (219) 440-1710
Enumeration DateJuly 30, 2024
Last NPPES UpdateOctober 3, 20242 updates tracked since enumeration
NPPES CertifiedOctober 3, 2024
✔ NPI 1982433819 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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.
Also ListedDentist · General PracticeTaxonomy 1223G0001X
8217 WICKER AVE, St. John, IN 46373
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Other Names 1

Doing Business AsSouthwest Pediatric Dental

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health.Insurance ›

Other Providers at the Same Location NPPES 4

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

DR. DANIEL MICHAEL BADE DDS
Dentist
8217 WICKER AVE
ST JOHN, IN 46373
Lake County (219) 558-8326
CREATING SMILES PC
Dentist (General Practice)
8217 WICKER AVE
ST JOHN, IN 46373
Lake County (219) 322-9920
SARA JACKSON DDS
Dentist (General Practice)
8217 WICKER AVE
SAINT JOHN, IN 46373
Lake County (219) 322-9920
SMILE SOLUTIONS INC
Dentist
8217 WICKER AVE
SAINT JOHN, IN 46373
Lake County (219) 558-8326

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 Northwest Pediatric Dental LLC's NPI number?

The NPI number for Northwest Pediatric Dental LLC is 1982433819. It was assigned to this organization in the NPPES registry on July 30, 2024. The provider is doing business as Southwest Pediatric Dental.

Where is Northwest Pediatric Dental LLC located?

Northwest Pediatric Dental LLC is located at 8217 Wicker Ave, St. John, IN 46373. The listed phone number is (219) 440-1710.

What is Northwest Pediatric Dental LLC's specialty?

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

What insurance does Northwest Pediatric Dental LLC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan and Ambetter from Meridian list Northwest Pediatric Dental LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Northwest Pediatric Dental LLC was last updated on October 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.