DR. RANDY KENT WALDRON (NPI# 1154395499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154395499 |
| Entity Type | Individual |
| Full Name | DR. RANDY KENT WALDRON |
| Credential | D.D.S. |
| Practice Address |
1302 S Main St Suite 5 Ottawa KS 66067-3527 |
| Practice Telephone | 7852422252 |
| Practice Fax Number | 7852422252 |
| Mailing Telephone | 7852422252 |
| Mailing Fax Number | 7852422252 |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
5481 | KS | Dental Providers |
| Street Address |
1302 S MAIN ST SUITE 5 |
| City | OTTAWA |
| State | KS |
| Zip Code | 66067-3527 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194100057 | Er Physicians South Pa | Emergency Medicine | 1302 S Main St, Ottawa, KS 66067-3527 | 2015-07-21 |
| 1477842292 | Dr T Gregory Dulos Optometrist Pa | Optometrist | 1302 S Main St, Ottawa, KS 66067-3527 | 2011-04-01 |
| 1447408372 | Hospice Care of Kansas, LLC | Hospice Care, Community Based | 1302 S Main St, Ottawa, KS 66067-3527 | 2008-09-04 |
| 1538123765 | Thomas Gregory Dulos | Optometrist | 1302 S Main St, Ottawa, KS 66067-3527 | 2006-04-14 |
| 1174518526 | Stephan Scott Corder | General Practice | 1302 S Main St, Ste 10, Ottawa, KS 66067-3527 | 2005-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407482870 | Katie Jean Turpin | Occupational Therapist | 3901 S Main St, Ottawa, KS 66067 | 2020-03-18 |
| 1619526464 | Jennifer Raybern | Specialist/Technologist | 1001 S Cedar St, Ottawa, KS 66067 | 2019-09-04 |
| 1508419938 | Custom Dental of Ottawa, Pa | Clinic/Center | 2030 S Princeton St, Ottawa, KS 66067 | 2019-07-24 |
| 1861948507 | Jeffrey Byrne Kelley | Pharmacist | 2101 S Princeton Rd, Ottawa, KS 66067 | 2016-09-01 |
| 1619185188 | Vintage Park At Ottawa LLC | Assisted Living Facility | 2250 S Elm St, Ottawa, KS 66067 | 2007-05-18 |
| 1356423495 | Ottawa Oral Surgery Lc | Dentist | 107 E 23rd St, Ste 3 Ottawa Oral Surgery Lc, Ottawa, KS 66067 | 2006-10-19 |
| 1669564332 | Sandra K Staneart | Nurse Practitioner | 1302 South Main St, Suite 1, Ottawa, KS 66067 | 2006-09-29 |
| 1467553214 | Nancy L Pauw | Social Worker | 2476 Reno Rd, Ottawa, KS 66067 | 2006-09-26 |
| 1700847043 | T.a. Rainbolt, Dds, P.a. | Dentist | 1334 S. Main Street, Ottawa, KS 66067 | 2006-03-28 |
| 1659341634 | Milton Laverne Sampson | Nurse Anesthetist, Certified Registered | 1301 S Main, Ottawa, KS 66067 | 2006-01-24 |
| Find all providers in zip 66067 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578773313 | Thomas Wesley Miller | Dentist | 111 W Glover St, Ottawa, IL 61350-3931 | 2007-05-23 |
| 1346453636 | John C Harbeck Dds PC | Dentist | 1210 W Madison St, Ottawa, IL 61350 | 2007-05-07 |
| 1265650691 | Robert William Schmidt | Dentist | 333 E Norris Dr, Ottawa, IL 61350-1518 | 2007-04-23 |
| 1447302773 | Hunter Clark Davis | Dentist | 230 W. Main St, Ottawa, IL 61350 | 2007-01-17 |
| 1275697666 | William Curtis Vesely | Dentist | 111 E Mckinley Rd, Ottawa, IL 61350-4801 | 2006-12-20 |
| 1821189606 | Lex E Gislar | Dentist | 113 E 11th St, Ottawa, KS 66067-3501 | 2006-09-27 |
| 1750489860 | David F. Poeppelman | Dentist | 1808 N Perry St, Ottawa, OH 45875-1129 | 2006-09-20 |
| 1669570263 | John Michael Conness | Dentist | 1704 Polaris Cir Ste 1, Ottawa, IL 61350-1774 | 2006-09-20 |
| 1225147937 | David Lee Meling | Dentist | 1704 Polaris Cir, Ottawa, IL 61350-1773 | 2006-08-29 |
| 1740299627 | Kevin Michael Cook | Dentist | 1404 Aquarius Cir, Ottawa, IL 61350-8914 | 2006-08-07 |
| Find all providers in OTTAWA | ||||
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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.