Professional Dental Alliance of Illinois Specialty, PLLC
NPI 1558145227ActiveOrganization· Dentist, Pediatric Dentistry· Long Grove, IL
Dentist, Pediatric Dentistry in Long Grove, Illinois, registered in NPPES in August 2023. The authorized official on file is Erica Quinteros, Credentialing.
Overview
| NPI | 1558145227 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 23, 2023 |
| Last updated in NPPES | Dec 13, 2023 |
| Certified by provider | Dec 13, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Pediatric Dentistry Primary | 1223P0221X | — | — |
| Dentist, General Practice | 1223G0001X | — | — |
| Dentist, Orthodontics and Dentofacial Orthopedics | 1223X0400X | — | — |
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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