Periodontics & Implants, LTD.

Periodontics · Evanston, IL

Organization Active NPI

NPI number 1962653600

Practice location

636 Church St
Suite 707
Evanston, IL 60201-4508
Phone
(847) 491-1880

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NPI record

NPI
1962653600
Entity type
Organization (Type 2)
Enumeration date
September 30, 2008
Last updated
September 30, 2008
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Periodontics Primary 1223P0300X 021000596 IL

Authorized official

Name
Dr. Richard C Prendergast, D.D.S., M.S.
Title
President/Periodontist
Phone
(847) 491-1880

About Periodontics & Implants, LTD.

Periodontics & Implants, LTD. is a healthcare organization registered in the NPI registry with the primary taxonomy Periodontics (code 1223P0300X). The practice location is 636 Church St, Suite 707, Evanston, IL 60201-4508. The NPI number 1962653600 was assigned on September 30, 2008 and the record was last updated on September 30, 2008.

Periodontics & Implants, LTD. lists a license in the registry: #021000596 (IL) for Periodontics. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is Dr. Richard C Prendergast, D.D.S., M.S., President/Periodontist.

Frequently asked questions

What is the NPI number of Periodontics & Implants, LTD.?

The NPI number is 1962653600.

What is the phone number of Periodontics & Implants, LTD.?

The phone number listed for the practice location is (847) 491-1880.

Where is Periodontics & Implants, LTD. located?

636 Church St, Suite 707, Evanston, IL 60201-4508.

What is the taxonomy code for Periodontics & Implants, LTD.?

The primary taxonomy code is 1223P0300X – Periodontics.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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