OrganizationActive
Fairview Heights Dentistry, PLLC
NPI 1811558208 · Dentist · Fairview Heights, IL
Fairview Heights Dentistry, PLLC is a Dentist organization in Fairview Heights, IL (NPI 1811558208).
Provider details
- NPI number
- 1811558208
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Organization subpart
- No
- Authorized official
- Bryan Watanabe, Owner(618) 310-0263
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(66/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 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
6407 N Illinois St
Fairview Heights, IL 62208-2720
Phone: (618) 310-0263
Fax: (618) 212-9054
Street-level locationGet directions
Mailing address
Po Box 920050
Dallas, TX 75392-0050
Other names (DBA / former)
- Doing business as
- Fairview Heights Dentistry
Registry dates
- Enumerated
- 2019-06-26
- Last updated
- 2022-03-08
- Certified
- 2022-03-08
Frequently asked questions
- What is Fairview Heights Dentistry, PLLC's NPI number?
- Fairview Heights Dentistry, PLLC's National Provider Identifier (NPI) is 1811558208, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Fairview Heights Dentistry, PLLC?
- Fairview Heights Dentistry, PLLC is classified in the NPPES registry as Dentist (Dental Providers).
- Where is Fairview Heights Dentistry, PLLC located?
- Fairview Heights Dentistry, PLLC's practice location on file with NPPES is 6407 N Illinois St, Fairview Heights, IL 62208-2720.
- What is Fairview Heights Dentistry, PLLC's phone number?
- The practice phone number listed in the NPPES registry for Fairview Heights Dentistry, PLLC is (618) 310-0263.
- Who is the authorized official for Fairview Heights Dentistry, PLLC?
- The authorized official listed on Fairview Heights Dentistry, PLLC's NPPES record is Bryan Watanabe, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Fairview Heights Dentistry, PLLC's NPI active?
- Yes — Fairview Heights Dentistry, PLLC's NPI (1811558208) is active in the NPPES registry as of the last update on 2022-03-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.