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

Northwest Pediatric Dental LLC

Organization General Practice Dentistry · NPI 1982433819

Northwest Pediatric Dental LLC is a General Practice Dentistry in St John, Indiana. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

8217 Wicker Ave
St John, IN 46373
Phone: (219) 440-1710
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X
General Practice Dentistry Taxonomy 1223G0001X

Record details

NPI number1982433819
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official James Mitsos — Owner · (219) 440-1710
Other names Southwest Pediatric Dental
NPI enumeratedJuly 30, 2024
Last updated in NPPESOctober 3, 2024
Certification dateOctober 3, 2024
Mailing address8217 Wicker Ave, St. John, IN 46373

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