Associated Dental Specialists of Long Grove Ltd
NPI 1033383567ActiveOrganization· Dentist, Pediatric Dentistry· Long Grove, IL
Dentist, Pediatric Dentistry in Long Grove, Illinois, registered in NPPES in April 2008. The authorized official on file is Mark L. Cannon, DDS, President.
Overview
| NPI | 1033383567 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 16, 2008 |
| Last updated in NPPES | Apr 16, 2008 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Pediatric Dentistry Primary | 1223P0221X | 060.003411019.021533 | IL |
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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