KIDIATRIC DENTISTRY, PLLC (NPI# 1073895629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073895629 |
| Entity Type | Organization |
| Organization Name | KIDIATRIC DENTISTRY, PLLC |
| Other Organization Name | KIDIATRIC DENTISTRY, PLLC |
| Practice Address |
913 E Warner Rd Gilbert AZ 85296-3078 |
| Practice Telephone | 6024181599 |
| Mailing Telephone | 6024181599 |
| Enumeration Date | 2011-09-09 |
| Last Update Date | 2011-09-09 |
| Authorized Official Name | DR. WALTER VILLANUEVA (PEDIATRIC DENTIST/OWNER) |
| Authorized Official Telephone | 6024181592 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
D7782 | AZ | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 436424 | 05 |
| Other Name | Type Code |
|---|---|
| Kidiatric Dentistry, PLLC | Doing Business As Name - Organization |
| Street Address |
913 E WARNER RD |
| City | GILBERT |
| State | AZ |
| Zip Code | 85296-3078 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124625793 | Gilbert Crossroads Kids' Dentists and Orthodontics, LLP | Dentist | 835 S. Gilbert Rd, Suite 104, Gilbert, AZ 85296 | 2020-10-06 |
| 1306455969 | Calm Care Living | Community/Behavioral Health | 1525 S Higley Rd, #104-6769, Gilbert, AZ 85296 | 2020-07-29 |
| 1366080970 | Hannah Golladay | Behavior Technician | 1166 S Gilbert Road, Suite 106, Mesa, AZ 85296 | 2019-12-13 |
| 1194284729 | Kege Health, LLC | Nurse Practitioner | 1206 E Warner Rd Ste 101f, Gilbert, AZ 85296 | 2019-03-13 |
| 1841757762 | Windhorse Counseling | Counselor | 1166 E Warner Road, Suite 203, Gilbert, AZ 85296 | 2019-02-27 |
| 1417424284 | Ashton N Wright | Behavior Technician | 1166 E Gilbert Rd, #106, Gilbert, AZ 85296 | 2018-10-30 |
| 1346717246 | Robison Orthodontics LLC | Dentist | 1355 S Higley Rd # 105, Gilbert, AZ 85296 | 2018-10-29 |
| 1518441831 | Kara Lyn Holyoak | Physician Assistant | 1359 S. Porter St., Gilbert, AZ 85296 | 2018-09-21 |
| 1225519119 | Jennifer Anne Goodman | Specialist/Technologist | 70 S Val Vista Dr A3, Gilbert, AZ 85296 | 2018-08-28 |
| 1437642329 | Greta Shumway | Counselor | 690 E. Warner Road, #115, Gilbert, AZ 85296 | 2018-06-14 |
| Find all providers in zip 85296 | ||||
| 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 |
|---|---|---|---|---|
| 1497396170 | Gilbert Kidtastic Dental LLC | Dentist | 3303 E Queen Creek Rd Ste 106, Gilbert, AZ 85297-8532 | 2019-10-03 |
| 1386207785 | Cattron's Dmd, Pllc | Dentist | 4024 E Guadalupe Rd Ste 105, Gilbert, AZ 85234-7672 | 2019-04-21 |
| 1487158473 | Jared Benjamin Tinker | Dentist | 3592 S Atherton Blvd Ste 107, Gilbert, AZ 85297-7444 | 2018-03-22 |
| 1184167447 | John E. Culp, IIi Dmd, PC | Dentist | 2080 E Williams Field Rd, Suite #104, Gilbert, AZ 85295-0702 | 2016-11-18 |
| 1871950071 | Joseph Creech | Dentist | 2550 E Guadalupe Rd Ste 101, Gilbert, AZ 85234-5114 | 2016-01-20 |
| 1861663635 | Gavin Cotant Christensen | Dentist | 3303 E Queen Creek Rd, Suite 106, Gilbert, AZ 85297-8532 | 2008-03-19 |
| 1285753574 | Timothy J Bashara | Dentist | 5656 S. Power Rd., Ste. 118, Gilbert, AZ 85295 | 2007-03-28 |
| 1780749333 | Abc Dentistry for Children | Dentist | 2363 E Baseline Rd, Gilbert, AZ 85234-2357 | 2006-12-26 |
| 1053488650 | Jared Weston Welch | Dentist | 3011 S Lindsay Rd Ste 108, Gilbert, AZ 85296-0702 | 2006-11-29 |
| 1881622165 | James C Johnson | Dentist | 1355 S Higley Rd Ste 117, Gilbert, AZ 85296-4789 | 2006-06-28 |
| Find all providers in GILBERT | ||||
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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.