# PEDIATRIC DENTAL SPECIALISTS

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1801268305
- **Authorized official:** DR. JANICE A LUBAS DDS (SECRETARY)
- **Authorized official phone:** (708) 424-1300

## Contact information

- **Practice address:** 6305 W 95TH ST, OAK LAWN, IL 60453-2255
- **Practice address phone:** (708) 424-1300
- **Mailing address:** 6305 W 95TH ST, OAK LAWN, IL 60453-2255
- **Mailing address phone:** (708) 424-1300

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 019020526 | IL | Yes |

## Other

- **Enumeration date:** 10/22/2015
- **Last updated:** 10/23/2015