PEDIATRIC DENTAL CENTER OF AVON, LLC (NPI# 1033562210) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033562210 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC DENTAL CENTER OF AVON, LLC |
| Practice Address |
44 Dale Rd Ste 305 Avon CT 06001-4351 |
| Practice Telephone | 8606748417 |
| Practice Fax Number | 8606748462 |
| Mailing Telephone | 8606748417 |
| Mailing Fax Number | 8606748462 |
| Enumeration Date | 2016-07-22 |
| Last Update Date | 2016-07-22 |
| Authorized Official Name | DR. JEANMARIE ANN COSGROVE (OWNER) |
| Authorized Official Telephone | 8606748417 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 002088559 | 05 |
| Street Address |
44 DALE RD STE 305 |
| City | AVON |
| State | CT |
| Zip Code | 06001-4351 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982968848 | Staci Robinson Allen | Dentist | 44 Dale Rd Ste 305, Avon, CT 06001-4351 | 2012-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285247338 | Alledran Med LLC | Durable Medical Equipment & Medical Supplies | 47 Avonwood Road, Unit #218, Avon, CT 06001 | 2020-08-28 |
| 1265053391 | 001care Inc | In Home Supportive Care | 20 Tower Lane, Avon, CT 06001 | 2020-04-29 |
| 1649813783 | Peoplesdental, P.C. | Dentist | 20 W Avon Rd Ste 104, Avon, CT 06001 | 2019-10-22 |
| 1740822063 | I E Consulting, LLC | Home Health | 1-5 East Main Street, Avon, CT 06001 | 2019-10-09 |
| 1598324261 | Prima Labs, LLC | Orthopaedic Surgery | Dr. Alexandra 58, Kezmarok, SLOVAKIA 06001 | 2019-06-06 |
| 1194220996 | Theresa L. Hixson | Social Worker | 152 Simsbury Rd., Building 9, Avon, CT 06001 | 2018-03-26 |
| 1851809974 | Kathleen Ann Subasic | Occupational Therapist | 19 Stockbridge Dr, Avon, CT 06001 | 2018-01-11 |
| 1801254297 | Vanessa Brodie | Psychologist | 395 W Avon Rd Ste 1, Avon, CT 06001 | 2016-02-01 |
| 1346614468 | Bryan Lilley | Physical Therapist | 34 Dale Rd., 202, Avon, CT 06001 | 2015-12-01 |
| 1073947446 | Rahel K. Saroff Counseling Services LLC | Counselor | 7 Towpath Lane, Avon, CT 06001 | 2013-08-21 |
| Find all providers in zip 06001 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588159339 | Kids Dentistree of In, LLC | Dentist | 7900 E Us Highway 36 Ste K, Avon, IN 46123-7791 | 2018-06-25 |
| 1336572791 | Todd Bernard | Dentist | 37701 Colorado Ave Ste E, Avon, OH 44011 | 2013-08-20 |
| 1982968848 | Staci Robinson Allen | Dentist | 44 Dale Rd Ste 305, Avon, CT 06001-4351 | 2012-06-26 |
| 1225209745 | Abha Pandey | Dentist | 110 N State Road 267, Avon, IN 46123-8475 | 2008-03-13 |
| 1922168566 | Jason Christopher Barb | Dentist | 37701 Colorado Avenue, Suite E, Avon, OH 44011 | 2006-12-12 |
| 1447226998 | Kidsmile, Inc. - John M. Venzel, D.m.d. | Dentist | 37701 Colorado Ave, Suite E, Avon, OH 44011-2840 | 2006-02-24 |
| 1801887633 | Ira M Greene | Dentist | 34 Dale Rd, Avon, CT 06001-3659 | 2005-11-01 |
| 1528405735 | Katherine Blair Bumgardner | Dentist | 8101 E Us Highway 36 Ste A, Avon, IN 46123-8082 | 2013-05-29 |
| 1992011548 | Kidsmile, Inc. - Jason C. Barb, Dds, Inc. | Dentist | 37701 Colorado Ave, Suite E, Avon, OH 44011-2840 | 2010-08-20 |
| 1598931610 | John Matthew Venzel | Dentist | 37701 Colorado Ave, Suite E, Avon, OH 44011 | 2008-05-08 |
| Find all providers in AVON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.