# CHICAGO PEDIATRIC DENTISTRY AND ORTHODONTICS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Chicago Pediatric Dentistry and Orthodontics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124629514
- **Authorized official:** DR. JUSTIN WELKE DDS (OWNER)
- **Authorized official phone:** (630) 886-1780

## Contact information

- **Practice address:** 1136 S DELANO CT W STE B202, CHICAGO, IL 60605-3734
- **Practice address phone:** (312) 766-0995
- **Mailing address:** 1136 S DELANO CT W STE B202, CHICAGO, IL 60605-3734
- **Mailing address phone:** (312) 437-0593

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | NULL | Yes |
| 1223P0221X | Pediatric Dentistry | — | — | Yes |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | — | NULL | — |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | — | — | — |
| 261QD0000X | Dental Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 11/03/2020
- **Last updated:** 06/30/2026