OrganizationActive
Crystal Lake Pediatric Dental Ltd.
NPI 1043311681 · Pediatric Dentistry · Crystal Lake, IL
Crystal Lake Pediatric Dental Ltd. is a Pediatric Dentistry organization in Crystal Lake, IL (NPI 1043311681).
Provider details
- NPI number
- 1043311681
- Entity type
- Organization
- Primary specialty
- Pediatric DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Anthony Minutillo, President(815) 356-7960
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
820 E Terra Cotta Ave
111
Crystal Lake, IL 60014-3649
Phone: (815) 356-7960
Fax: (815) 356-8051
Approximate (ZIP-level) locationGet directions
Mailing address
820 E Terra Cotta Ave
Crystal Lake, IL 60014-3649
Registry dates
- Enumerated
- 2006-09-26
- Last updated
- 2020-08-22
Frequently asked questions
- What is Crystal Lake Pediatric Dental Ltd.'s NPI number?
- Crystal Lake Pediatric Dental Ltd.'s National Provider Identifier (NPI) is 1043311681, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Crystal Lake Pediatric Dental Ltd.?
- Crystal Lake Pediatric Dental Ltd. is classified in the NPPES registry as Pediatric Dentistry (Dental Providers).
- Where is Crystal Lake Pediatric Dental Ltd. located?
- Crystal Lake Pediatric Dental Ltd.'s practice location on file with NPPES is 820 E Terra Cotta Ave, Crystal Lake, IL 60014-3649.
- What is Crystal Lake Pediatric Dental Ltd.'s phone number?
- The practice phone number listed in the NPPES registry for Crystal Lake Pediatric Dental Ltd. is (815) 356-7960.
- Who is the authorized official for Crystal Lake Pediatric Dental Ltd.?
- The authorized official listed on Crystal Lake Pediatric Dental Ltd.'s NPPES record is Anthony Minutillo, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Crystal Lake Pediatric Dental Ltd.'s NPI active?
- Yes — Crystal Lake Pediatric Dental Ltd.'s NPI (1043311681) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.