Pediatric Dental Surgical Associates PLLC
NPI 1013480755ActiveOrganization· Dentist, Pediatric Dentistry· Chicago, IL
Dentist, Pediatric Dentistry in Chicago, Illinois, registered in NPPES in January 2019. The authorized official on file is Johnny Kuttab, Ceo.
Overview
| NPI | 1013480755 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 4, 2019 |
| Last updated in NPPES | Jan 4, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Pediatric Dentistry Primary | 1223P0221X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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