Dental Professionals of Illinois, PC
NPI 1902269079ActiveOrganization· Dentist, General Practice· Lockport, IL
Dentist, General Practice in Lockport, Illinois, registered in NPPES in April 2016, part of Dental Professionals of Illinois, PC. The authorized official on file is Kendra Walker, Credentialing Team Lead.
Overview
| NPI | 1902269079 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Dental Professionals of Illinois, PC |
| NPI issued | Apr 5, 2016 |
| Last updated in NPPES | Apr 5, 2016 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | — | — |
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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