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

Pediatric Dentistry of Northern Illinois Ltd

Organization Pediatric Dentistry · NPI 1376651679

Pediatric Dentistry of Northern Illinois Ltd is a Pediatric Dentistry in Rockford, Illinois. Licensed in Illinois. Registered with an NPI since 2006.

Licensed in
IL
In the registry since
2006
Specialties on file
2
What do these letters mean?
Ltd — Limited
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4903 E State St
Rockford, IL 61108
Phone: (815) 398-2323
Fax: (815) 398-2328
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X (IL)
Pediatric Dentistry Taxonomy 1223P0221X · Licence 019 (IL)

Record details

NPI number1376651679
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeffrey Johnson — Pediatric Dentist Owner President · (815) 398-2323
NPI enumeratedAugust 27, 2006
Last updated in NPPESAugust 22, 2020
Mailing address4903 E State St, Rockford, IL 61108

Other providers in Rockford