SPRING CREEK PEDIATRIC DENTISTRY PLLC (NPI# 1255816104) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255816104 |
| Entity Type | Organization |
| Organization Name | SPRING CREEK PEDIATRIC DENTISTRY PLLC |
| Practice Address |
590 Fire Station Rd Ste C Clarksville TN 37043-4016 |
| Practice Telephone | 9316489930 |
| Mailing Telephone | 9316489930 |
| Enumeration Date | 2018-09-26 |
| Last Update Date | 2019-05-03 |
| Authorized Official Name | DR. KEVIN KENNEDY JR. (DENTIST) |
| Authorized Official Telephone | 9312060852 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 1527793 | 05 |
| Street Address |
590 FIRE STATION RD STE C |
| City | CLARKSVILLE |
| State | TN |
| Zip Code | 37043-4016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629399647 | Kevin Chambliss Kennedy Jr. | Dentist | 590 Fire Station Rd Ste C, Clarksville, TN 37043-4016 | 2010-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952958464 | Barbara Gallahan | Technician | 3992 Lakewood Dr., Clarksville, TN 37043 | 2019-08-20 |
| 1144874728 | Intricate Care | Registered Nurse | 2299 Raleigh Ct, Clarksville, TN 37043 | 2019-07-31 |
| 1740842145 | Caila Anne Wiblitzhouser Holm | Counselor | 755 Weatherly Drive, Clarksville, TN 37043 | 2019-07-05 |
| 1407416407 | Heartland Dental Care of Tennessee, PC | Dentist | 930 Highway 76, Clarksville, TN 37043 | 2019-06-20 |
| 1376021501 | Stephen Lawrence Rego | Case Manager/Care Coordinator | Cohen Military Family Clinic, 775 Weatherly Dr, Clarksville, TN 37043 | 2018-07-31 |
| 1366928095 | Kendra Lee | Social Worker | 775 Weatherly Dr., Clarksville, TN 37043 | 2018-07-16 |
| 1245742931 | Andrea L Edelstein | Dentist | 1818 Memorial Dr., Unit 47, Clarksville, TN 37043 | 2017-11-02 |
| 1043736119 | Megan Pritchett Landre | Behavior Technician | 990 South Ridge Trail, Clarksville, TN 37043 | 2017-08-20 |
| 1932624798 | Sandra Melissa Corral | Behavior Technician | 139e Old Trenton Rd, Suite B, Clarksville, TN 37043 | 2017-08-13 |
| 1700306032 | Sahiti Kandati | Dentist | 1777 Madison Ste Ste 100, Clarksville, TN 37043 | 2017-06-27 |
| Find all providers in zip 37043 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417557380 | Ironwood Dental | Clinic/Center | 2550 Madison St, Clarksville, TN 37043-3704 | 2020-10-29 |
| 1134611890 | Skees Family Dentistry, Pllc. | Clinic/Center | 1370 Veterans Pkwy Ste 1500, Clarksville, IN 47129-8705 | 2018-05-30 |
| 1043586720 | Clarksville Children's Dentistry and Orthodontics | Clinic/Center | 495 Dunlop Ln, Suite 112, Clarksville, TN 37040 | 2012-03-28 |
| 1396010310 | Bridges Dental Care, LLC | Clinic/Center | 2313 Rudolphtown Rd, Clarksville, TN 37043-2228 | 2012-03-09 |
| 1780829200 | Robert P. Smith, D.d.s | Clinic/Center | 105 N Cravens St, Clarksville, AR 72830-3025 | 2008-12-12 |
| 1174768758 | Arkansas River Valley Dentistry | Clinic/Center | 1101 E Poplar St, Clarksville, AR 72830-4420 | 2008-12-10 |
| 1750308300 | Rashmi K. Parmar D.m.d., P.C. | Clinic/Center | 12620 State Route 108, Clarksville, MD 21029-1532 | 2006-07-17 |
| 1568062685 | Kerry Carlson Dds,pllc | Clinic/Center | 1619 W Main St Ste A, Clarksville, AR 72830-3225 | 2020-10-28 |
| 1326518390 | Caprock Dental Pllc | Clinic/Center | 220 Hillcrest Dr, Clarksville, TN 37043-6520 | 2018-12-03 |
| 1871834192 | H Herbert Benavent Dds Pa | Clinic/Center | 5820 Clarksville Square Dr, Clarksville, MD 21029-1856 | 2013-03-12 |
| Find all providers in CLARKSVILLE | ||||
| City | CLARKSVILLE |
| Zip Code | 37043 |
Please comment or provide details below to improve the information on SPRING CREEK PEDIATRIC DENTISTRY PLLC.
| 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.