LW PEDIATRIC DENTISTRY PA (NPI# 1104450121) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104450121 |
| Entity Type | Organization |
| Organization Name | LW PEDIATRIC DENTISTRY PA |
| Practice Address |
6910 Lake Worth Rd Lake Worth FL 33467-2978 |
| Practice Telephone | 5617707321 |
| Practice Fax Number | 5617250762 |
| Mailing Telephone | 5617707321 |
| Mailing Fax Number | 5617250762 |
| Enumeration Date | 2020-02-28 |
| Last Update Date | 2020-02-28 |
| Authorized Official Name | DR. DREW POPPER (OWNER) |
| Authorized Official Telephone | 2034156875 |
| 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 |
|---|---|---|---|
| FL | 017151100 | 05 |
| Street Address |
6910 LAKE WORTH RD |
| City | LAKE WORTH |
| State | FL |
| Zip Code | 33467-2978 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295801652 | Evan Howard Ledis | Dentist | 6910 Lake Worth Rd, Lake Worth, FL 33467-2903 | 2006-11-28 |
| 1063610335 | Bradley Feuer | Family Medicine | 6910 Lake Worth Rd, Lake Worth, FL 33467-2903 | 2007-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891259537 | Paulette Penning | Nurse Practitioner | Clinic 7891 8954 Lantana Rd, Lake Worth, FL 33467 | 2019-01-28 |
| 1700357183 | Dara Gill | Physical Therapist | 9897 Lake Worth Rd Ste 203, Lake Worth, FL 33467 | 2018-12-11 |
| 1609344977 | Farah Edwidge Johanne Sajous | Nurse Practitioner | 9351 Pinto Dr, Lake Worth, FL 33467 | 2018-11-05 |
| 1386110138 | Juliana Escamilla | Massage Therapist | 390 Bennington Lane, Apt B, Lake Worth, FL 33467 | 2018-10-19 |
| 1609369453 | Courtney Kehaulani Linke | Occupational Therapist | 4602 Sandy Cove Ter, Lake Worth, FL 33467 | 2018-06-07 |
| 1821589862 | Matthew James Dowda | Physical Therapy Assistant | 5342 Evening Star Way, Lake Worth, FL 33467 | 2018-05-25 |
| 1053828954 | Ailema Bayola Perez | Dentist | 3935 Jog Rd, Suite 16, Greenacres, FL 33467 | 2018-01-02 |
| 1922517424 | Metro Physical & Occupational Therapy Inc | Occupational Therapist | 9130 Hypoluxo Road, Lake Worth, FL 33467 | 2017-09-27 |
| 1659806826 | Advanced Placement Medical Products, LLC | Durable Medical Equipment & Medical Supplies | 9627 Bergamo Street, Lake Worth, FL 33467 | 2017-04-26 |
| 1700326378 | Doctor's Choice Medical Center, Inc | Clinic/Center | 2994 S Jog Rd Ste A, Greenacres, FL 33467 | 2017-03-02 |
| Find all providers in zip 33467 | ||||
| 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 |
|---|---|---|---|---|
| 1740626118 | Sarah Lee Shin-kim | Dentist | 7109 Navajo Trl, Lake Worth, TX 76135-3946 | 2013-05-13 |
| 1740480417 | Gonzalo Cortes | Dentist | 1708 N Federal Hwy, Lake Worth, FL 33460-6668 | 2007-07-20 |
| 1689611527 | E. Dale Martin, D.d.s., M.s.d., P.C. | Dentist | 3904 Boat Club Rd, Lake Worth, TX 76135-3201 | 2006-05-31 |
| 1235217571 | Victor Raul Oramas | Dentist | 6169 Jog Rd, Suite B-5, Lake Worth, FL 33467-6579 | 2006-11-02 |
| 1215034962 | Fara Bender | Dentist | 6169 Jog Rd, Suite B-5, Lake Worth, FL 33467-6579 | 2006-09-17 |
| 1144261975 | Eddy Dale Martin | Dentist | 3904 Boat Club Rd, Lake Worth, TX 76135-3201 | 2006-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073113296 | Pediatric Dental Center of Gardens Inc | Dentist | 18244 Nw 27th Ave, Miami Gardens, FL 33056-3501 | 2020-10-27 |
| 1205446598 | Harp Pediatric Dentistry | Dentist | 31067 Us Highway 19 N, Palm Harbor, FL 34684-4416 | 2020-08-03 |
| 1043829377 | Little Champions Pediatric Dentistry | Dentist | 1330 Sw 22nd St Ste 406, Miami, FL 33145-2945 | 2020-07-22 |
| 1710595509 | Bright Smiles Pediatric Dentistry Nassau LLC | Dentist | 960135 Gateway Blvd, Fernandina Beach, FL 32034-9120 | 2020-07-17 |
| 1578180097 | Juliana Grace Fitzgerald | Dentist | 7505 Grand Lely Dr Bldg 1, Naples, FL 34113-1753 | 2020-06-30 |
| 1861012569 | Toni-marie Small | Dentist | 12625 76th Rd N, West Palm Beach, FL 33412-2259 | 2020-04-22 |
| 1003446824 | Spring Hill Pediatric Dentistry, LLC | Dentist | 7140 Sagheer St., Brooksville, FL 34613 | 2020-01-21 |
| 1114573086 | Kids Dentist LLC | Dentist | 8058 W Mcnab Rd, North Lauderdale, FL 33068-4254 | 2019-08-15 |
| 1558915157 | Dentistry for Children of Florida, Pllc | Dentist | 3021 Airport Rd N Ste 203, Naples, FL 34105-3077 | 2019-07-31 |
| 1528620937 | Catherine Jane Graham | Dentist | 1395 Center Dr Rm D11-6, Gainesville, FL 32610-3006 | 2019-07-05 |
| Find all providers with the same taxonomy | ||||
| City | LAKE WORTH |
| Zip Code | 33467 |
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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.