DR. JERRY WAYNE GODKIN (NPI# 1225253669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225253669 |
| Entity Type | Individual |
| Full Name | DR. JERRY WAYNE GODKIN |
| Credential | DDS MSD |
| Practice Address |
17059 Stuebner Airline Rd Spring TX 77379-6210 |
| Practice Telephone | 2814443999 |
| Practice Fax Number | 2814448079 |
| Mailing Telephone | 2814443999 |
| Mailing Fax Number | 2814448079 |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2016-10-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
TX8947 | TX | Dental Providers |
| Street Address |
17059 STUEBNER AIRLINE RD |
| City | SPRING |
| State | TX |
| Zip Code | 77379-6210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417383969 | Kiwi Pediatric Dental Group Pllc | Dentist | 17059 Stuebner Airline Rd, Spring, TX 77379 | 2013-09-16 |
| 1881918753 | Lisa Marie Trevino | Dentist | 17059 Stuebner Airline Rd, Spring, TX 77379 | 2010-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174158661 | Hira Assad | Dentist | Spring Klein Endodontics, 6078 Farm To Market 2920, Spring, TX 77379 | 2020-03-05 |
| 1366924433 | Alicia R Horn | Counselor | 7109 Farm To Market 2920, Suite 600, Spring, TX 77379 | 2018-09-05 |
| 1235631714 | Jessica Renee Borrego | Physical Therapist | 16835 Deer Creek Driv, Spring, TX 77379 | 2018-03-01 |
| 1992217640 | Brianna Williams | Occupational Therapist | 17015 Lazy Hill Ln, Spring, TX 77379 | 2017-11-02 |
| 1558885392 | Quality Living Home Care,llc | In Home Supportive Care | 7614 Theisswood Rd, Spring, TX 77379 | 2017-08-02 |
| 1558899518 | Stuart James Rooney | Dentist | 8419 Louetta Rd Ste A, Spring, TX 77379 | 2017-06-02 |
| 1336674357 | Sonia Ann Varghese | Student in an Organized Health Care Education/Training Program | 7031 Villa Mountain Ln, Spring, TX 77379 | 2017-04-27 |
| 1063950459 | Magnificat Primary Care LLC | Clinic/Center | 17835 Kuykendahl Road, Spring, TX 77379 | 2017-02-06 |
| 1609312784 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 10833 Gleannloch Forest Drive, Spring, TX 77379 | 2017-01-12 |
| 1467996025 | U S Anesthesia Partners of Texas, Pa | Anesthesiology | 8687 Louetta Rd Ste 275, Spring, TX 77379 | 2016-12-15 |
| Find all providers in zip 77379 | ||||
| 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 |
|---|---|---|---|---|
| 1164048237 | Scott A Andersen Dds Pllc | Dentist | 30014 Aldine Westfield Rd Ste 101, Spring, TX 77386-2994 | 2020-06-24 |
| 1861945388 | Scd,pllc | Dentist | 2833 Riley Fuzzel Rd, Suite #500, Spring, TX 77386 | 2016-08-02 |
| 1376926279 | Hklp,pllc | Dentist | 19380 I-45, Suite #110, Spring, TX 77373 | 2015-07-09 |
| 1558412890 | Carl Eugene Pittman | Dentist | 9316 Louetta Rd, Spring, TX 77379-6520 | 2007-01-15 |
| 1114923430 | Richard Lewis Matthews Jr. | Dentist | 20423 Kuykendahl Rd, Ste 600, Spring, TX 77379-3322 | 2005-06-22 |
| 1992249296 | Robert Benson Freele | Dentist | 1202 Chelshurst Way, Spring, TX 77379-3247 | 2016-12-06 |
| 1043648181 | Mona Pediatric Dentist, Pllc | Dentist | 20920 Kuykendahl Rd, Suite E, Spring, TX 77379-3378 | 2013-10-29 |
| 1417383969 | Kiwi Pediatric Dental Group Pllc | Dentist | 17059 Stuebner Airline Rd, Spring, TX 77379 | 2013-09-16 |
| 1881918753 | Lisa Marie Trevino | Dentist | 17059 Stuebner Airline Rd, Spring, TX 77379 | 2010-03-22 |
| 1851410955 | Craig Kenneth Brown | Dentist | 9316 Louetta Rd, Spring, TX 77379-6520 | 2007-03-28 |
| Find all providers in SPRING | ||||
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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.