Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Fairview Heights Dentistry, PLLC

Organization Dentist · NPI 1811558208

Fairview Heights Dentistry, PLLC is a Dentist in Fairview Heights, Illinois. Registered with an NPI since 2019.

In the registry since
2019
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

6407 N Illinois St
Fairview Heights, IL 62208-2720
Phone: (618) 310-0263
Fax: (618) 212-9054
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X

Record details

NPI number1811558208
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Bryan Watanabe — Owner · (618) 310-0263
Other names Fairview Heights Dentistry
NPI enumeratedJune 26, 2019
Last updated in NPPESMarch 8, 2022
Certification dateMarch 8, 2022
Mailing addressPo Box 920050, Dallas, TX 75392-0050

Other providers in Fairview Heights