KNICKERBOCKER PEDIATRIC DENTISTRY LLC (NPI# 1447617006) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447617006 |
| Entity Type | Organization |
| Organization Name | KNICKERBOCKER PEDIATRIC DENTISTRY LLC |
| Practice Address |
1 Childrens Plz Dayton OH 45404-1873 |
| Mailing Address |
Po Box 752144 Dayton OH 45475-2144 |
| Practice Telephone | 9376199828 |
| Enumeration Date | 2016-01-26 |
| Last Update Date | 2016-01-26 |
| Authorized Official Name | BETTY HUANG (PRESIDENT) |
| Authorized Official Telephone | 4194630023 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
30-023424 | OH | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0054438 | 05 |
| Street Address |
1 CHILDRENS PLZ |
| City | DAYTON |
| State | OH |
| Zip Code | 45404-1873 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124021324 | Dayton Children's Orthopaedic Center for Spinal & Pediatric Care, LLC | Specialist | 1 Childrens Plz, Dayton, OH 45404 | 2005-05-23 |
| 1346840782 | Lillian Delatore | Dietitian, Registered | 1 Childrens Plz, Dayton, OH 45404-1873 | 2020-10-26 |
| 1760081434 | Jennifer P Slye | Counselor | 1 Childrens Plz, Dayton, OH 45404-1815 | 2020-10-22 |
| 1255942868 | Dayton Children's Hospital | Pharmacy | 1 Childrens Plz, Dayton, OH 45404-1815 | 2020-08-17 |
| 1851917744 | Kylie Lynn Yike | Dietitian, Registered | 1 Childrens Plz, Dayton, OH 45404-1815 | 2020-06-17 |
| 1750901211 | Mitchell Alexander Mcclellan | Student in an Organized Health Care Education/Training Program | 1 Childrens Plz, Dayton, OH 45404-1873 | 2020-04-24 |
| 1902426935 | Preston Keiffer | Student in an Organized Health Care Education/Training Program | 1 Childrens Plz, Dayton, OH 45404-1815 | 2020-04-20 |
| 1336768829 | Emily Dippold | Physician Assistant | 1 Childrens Plz, Dayton, OH 45404-1873 | 2020-04-14 |
| 1811516875 | Courtney Ann Pierron | Student in an Organized Health Care Education/Training Program | 1 Childrens Plz, Dayton, OH 45404-1873 | 2020-04-10 |
| 1790304905 | Kate Redding Boroff | Student in an Organized Health Care Education/Training Program | 1 Childrens Plz, Dayton, OH 45404-1873 | 2020-04-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134587108 | Addison Home Health Services LLC | Nursing Care | 1819 Troy St Ste 3, Dayton, OH 45404 | 2016-02-05 |
| 1437593951 | Ronna Sue Tilley | Licensed Practical Nurse | 550 Dawes Avenue, Dayton, OH 45404 | 2013-04-26 |
| 1932397544 | Children's Anesthesia Group Inc | Anesthesiology | 1 Children's Plz, Dayton, OH 45404 | 2007-10-09 |
| 1922135292 | Donald J Elsbernd Dds Inc | Dentist | 825 Troy St, Dayton, OH 45404 | 2007-02-27 |
| 1124172036 | Mary Ann Wallace | Home Delivered Meals | 900 Troy Street, Dayton, OH 45404 | 2007-01-22 |
| 1225094287 | Ann E Burke | Pediatrics | One Childrens Plaza, Dayton, OH 45404 | 2006-04-26 |
| 1508838244 | Virginia G Matheson | Psychiatry & Neurology | Dayton Children's Hospital, One Children's Plaza, Dayton, OH 45404 | 2006-02-06 |
| 1952921710 | Daniel Oder | Student in an Organized Health Care Education/Training Program | 1 Children's Plaza, Dayton Children's Hospital, Cheri Russell, Dayton, OH 45404 | 2020-04-22 |
| 1356802276 | Alec Kelley | Student in an Organized Health Care Education/Training Program | Dayton Children's Hospital, One Children's Plaza, Dayton, OH 45404 | 2019-03-26 |
| 1205360831 | Chiara Foster | Student in an Organized Health Care Education/Training Program | 1 Childrens Plaza, Dayton, OH 45404 | 2017-04-20 |
| Find all providers in zip 45404 | ||||
| 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 |
|---|---|---|---|---|
| 1861629099 | Amanda R. Medina | Dentist | 1 Childrens Plz, Suite 2070, Dayton, OH 45404-1898 | 2009-06-15 |
| 1447496476 | Hensley Pediatric Dentistry, Inc. | Dentist | 1 Childrens Plz, Suite 2070, Dayton, OH 45404-1898 | 2008-12-22 |
| 1518062231 | Stacey Elizabeth Zaikoski | Dentist | 5671 Far Hills Ave, Dayton, OH 45429-2226 | 2006-09-14 |
| 1881618619 | Kyle Martin Hensley | Dentist | One Children's Plaza, Dayton Pediatric Dentistry, Dayton, OH 45404 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255931911 | Rachel I Rosen, Dds LLC | Dentist | 9964 Vail Dr Ste 1, Twinsburg, OH 44087-2972 | 2020-10-30 |
| 1861014334 | Page Pediatric Dentistry | Dentist | 5699 Innovation Dr, Dublin, OH 43016-3312 | 2020-05-07 |
| 1629602412 | Tuka N/a Sada | Dentist | 9601 Chester Ave Rm 284-h, Cleveland, OH 44106-1666 | 2020-03-02 |
| 1992336093 | Al Saad Dental LLC | Dentist | 7250 Center St Ste C, Mentor, OH 44060-4920 | 2020-01-28 |
| 1912547811 | Cincy Pediatric Dentistry, LLC | Dentist | 1131 Cryer Ave, Cincinnati, OH 45208 | 2020-01-09 |
| 1790338168 | Corbin Salthouse | Dentist | 13390 Cedar Rd, Cleveland Heights, OH 44118-2955 | 2019-07-24 |
| 1588223929 | Amber Sun | Dentist | 11100 Euclid Ave # Rb&c1200, Cleveland, OH 44106-1716 | 2019-06-10 |
| 1710546437 | Kyle R. Jackson, Dds, LLC | Dentist | 4090 Indian Ripple Rd Unit 102, Beavercreek, OH 45440-3253 | 2019-06-06 |
| 1932764107 | Cuadra Pediatric Dentistry, LLC | Dentist | Cuadra Pediatric Dentistry, LLC, 486 Wentz Street, Tiffin, OH 44883 | 2019-05-03 |
| 1265901136 | Ohio Dental Team LLC | Dentist | 7690 First Place, Bldg D, Suite E, Oakwood, OH 44146 | 2018-11-20 |
| Find all providers with the same taxonomy | ||||
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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.