# SPRINGFIELD PEDIATRIC DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sirisha Govindaiah DDS, PLLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497210546
- **Authorized official:** DR. SIRISHA GOVINDAIAH BDS, MPH, DDS (DENTIST/PRESIDENT)
- **Authorized official phone:** (217) 666-0098

## Contact information

- **Practice address:** 1224 CENTRE WEST DR, SPRINGFIELD, IL 62704-2184
- **Practice address phone:** (217) 666-0098
- **Mailing address:** 10900 FOX CRST, SAN ANTONIO, TX 78233-7249
- **Mailing address phone:** (217) 666-0098

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | NULL | Yes |
| 1223P0221X | Pediatric Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 02/04/2019
- **Last updated:** 02/04/2019