BOWLING GREEN PEDIATRIC DENTAL GROUP INC (NPI# 1477611333) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477611333 |
| Entity Type | Organization |
| Organization Name | BOWLING GREEN PEDIATRIC DENTAL GROUP INC |
| Practice Address |
1221 Ridgewood Drive Suite B Bowling Green OH 43402-2667 |
| Practice Telephone | 4193522593 |
| Practice Fax Number | 4193544717 |
| Mailing Telephone | 4193522593 |
| Mailing Fax Number | 4193544717 |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. FRANK LOUIS PACE (PRESIDENT) |
| Authorized Official Telephone | 4193522593 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
30014316 | OH | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0587262 | 05 |
| Street Address |
1221 RIDGEWOOD DRIVE SUITE B |
| City | BOWLING GREEN |
| State | OH |
| Zip Code | 43402-2667 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003974965 | Frank Louis Pace Jr. | Dentist | 1221 Ridgewood Drive, Suite B, Bowling Green, OH 43402-2667 | 2006-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316592017 | Danielle Urbaniak | Pharmacist | 722-740 South Main St, Bowling Green, OH 43402 | 2019-08-08 |
| 1013485648 | Julie Marie Knapp | Counselor | 219 South Church Street, Bowling Green, OH 43402 | 2018-11-13 |
| 1477065274 | Elizabeth Marie Leber | Social Worker | 1045 Klotz Rd., Bowling Green, OH 43402 | 2017-11-02 |
| 1558871913 | Genoa Healthcare, LLC | Pharmacy | 1010 N Prospect St Ste 56, Bowling Green, OH 43402 | 2017-10-11 |
| 1093224933 | Kevin Wagner | Contractor | 19644 Hull Prairie Rd, Bowling Green, OH 43402 | 2017-09-22 |
| 1487102273 | Mary Ann Bostdorff | Registered Nurse | 1011 North Prospect St., Bowling Green, OH 43402 | 2016-09-21 |
| 1174927354 | Kristy Siegle | Counselor | 1010 North Prospect, Bowling Green, OH 43402 | 2014-10-16 |
| 1366846560 | Timothy M Burkart | Pharmacist | 1840 E. Gypsy Lane Rd, (wood County Health Department), Bowling Green, OH 43402 | 2014-10-16 |
| 1144629411 | Ledeithra Denise Mckinney | Speech-Language Pathologist | 1921 East Gypsy Lane Rd., Bowling Green, OH 43402 | 2014-08-22 |
| 1558701607 | Mark Joseph Kleeberger | Physical Therapy Assistant | 1180 N Main St, Bowling Green, OH 43402 | 2013-07-02 |
| Find all providers in zip 43402 | ||||
| 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 |
|---|---|---|---|---|
| 1740564855 | J. Scott Barbee, Dmd, Psc | Dentist | 1830 Destiny Ln Ste 119, Bowling Green, KY 42104-1089 | 2011-10-07 |
| 1487750956 | Erin Courtney Elliott | Dentist | 120 Callaway Ct, Bowling Green, KY 42103 | 2006-09-15 |
| 1659480275 | Randall Harley Elliott | Dentist | 120 Callaway Court, Bowling Green, KY 42103 | 2006-08-29 |
| 1083067482 | Pediatric Dentistry of Southern Kentucky | Dentist | 234 Natchez Trace Ave, Bowling Green, KY 42103-7995 | 2016-07-20 |
| 1538505615 | Matthew Nicholson Damin | Dentist | 1830 Destiny Ln, Suite 119, Bowling Green, KY 42104-1087 | 2013-05-16 |
| 1336481720 | Frank D Tuzzio IIi | Dentist | 1221 Ridgewood Dr, Suite B, Bowling Green, OH 43402-2787 | 2013-03-23 |
| 1205997236 | Jeffrey Scott Barbee | Dentist | 1830 Destiny Ln, St 119, Bowling Green, KY 42104 | 2006-12-13 |
| 1003974965 | Frank Louis Pace Jr. | Dentist | 1221 Ridgewood Drive, Suite B, Bowling Green, OH 43402-2667 | 2006-12-04 |
| 1821107442 | Drs Erin and Randy Elliott Pediatric Dentistry | Dentist | 120 Callaway Court, Bowling Green, KY 42103 | 2006-08-29 |
| 1558356030 | Jack Allen Whittaker | Dentist | 960 W Wooster St, Ste. 201, Bowling Green, OH 43402-2644 | 2005-09-12 |
| Find all providers in BOWLING GREEN | ||||
| City | BOWLING GREEN |
| Zip Code | 43402 |
Please comment or provide details below to improve the information on BOWLING GREEN PEDIATRIC DENTAL GROUP INC.
| 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.