OrganizationActive
Pediatric Dentistry of Northern Illinois Ltd
NPI 1376651679 · Pediatric Dentistry · Rockford, IL
Provider details
- NPI number
- 1376651679
- Entity type
- Organization
- Primary specialty
- Pediatric DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Jeffrey Johnson, Pediatric Dentist Owner President(815) 398-2323
- License
- 019 (IL)
Specialties & taxonomies
Dental Providers
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
4903 E State St
Rockford, IL 61108
Phone: (815) 398-2323
Fax: (815) 398-2328
Street-level locationGet directions
Mailing address
4903 E State St
Rockford, IL 61108
Registry dates
- Enumerated
- 2006-08-27
- Last updated
- 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.