# JOYFUL SMILES PEDIATRIC DENTISTRY OF BRADLEY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417637158
- **Authorized official:** YAA NOEL MCDONALD DMD (PRESIDENT/PEDIATRIC DENTIST)
- **Authorized official phone:** (773) 290-3500

## Contact information

- **Practice address:** 840 N KINZIE AVE, BRADLEY, IL 60915-1231
- **Practice address phone:** (815) 935-5560
- **Mailing address:** PO BOX 349, BRADLEY, IL 60915-0349
- **Mailing address phone:** (815) 935-5560

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | — |
| 122300000X | Dentist | — | — | — |
| 1223P0221X | Pediatric Dentistry | — | NULL | Yes |
| 1223P0221X | Pediatric Dentistry | — | — | Yes |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | — | NULL | — |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | — | — | — |

## Other

- **Enumeration date:** 07/18/2023
- **Last updated:** 07/18/2023