PEDIATRIC DENTAL ASSOCIATES PC (NPI# 1477678167) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477678167 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC DENTAL ASSOCIATES PC |
| Practice Address |
7750 West Jefferson Blvd Fort Wayne IN 46804-4174 |
| Practice Telephone | 2604590903 |
| Practice Fax Number | 2604590673 |
| Mailing Telephone | 2604590903 |
| Mailing Fax Number | 2604590673 |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. ANDREW STEVEN HOBBS (PRESIDENT OWNER) |
| Authorized Official Telephone | 2604590903 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
54001532A | IN | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | DEPTHEALTH CHILDRENS SHCS | 104667 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447328349 | Pediatric Dental Associates PC | Dentist | 1103 Walnut Drive, Pediatric Dental Associates PC, Ardmore, OK 73401 | 2006-12-01 |
| 1467462622 | Pediatric Dental Associates PC | Dentist | 195 Arlington Hts Rd, St 150, Buffalo Grove, IL 60089 | 2006-08-09 |
| Street Address |
7750 WEST JEFFERSON BLVD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46804-4174 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104859701 | Pediatric Dentistry Inc | Dentist | 7750 West Jefferson Blvd, Fort Wayne, IN 46804-4136 | 2006-07-08 |
| 1851305239 | Andrew Steven Hobbs | Dentist | 7750 West Jefferson Blvd, Fort Wayne, IN 46804-4136 | 2006-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350344 | Derek Mumaw | Physical Therapist | 8420 Illinois Rd, Fort Wayne, IN 46804 | 2020-09-15 |
| 1942840228 | Erin M Mason | Behavior Technician | 5601 Coventry Ln, Fort Wayne, IN 46804 | 2020-01-14 |
| 1346880879 | Emily A Abdalla | Behavior Technician | 5601 Coventry Ln., Fort Wayne, IN 46804 | 2020-01-13 |
| 1083265433 | Fort Wayne Endodontics | Dentist | 9407 Illinois Rd, Fort Wayne, IN 46804 | 2019-09-26 |
| 1689140949 | Harrison Dental Group II, LLC | Dentist | 1333 Getz Rd, Fort Wayne, IN 46804 | 2018-10-15 |
| 1346731908 | Erin Nicole Zimmerman | Nurse Practitioner | 10170 Illinois Rd # 14, Fort Wayne, IN 46804 | 2018-05-19 |
| 1417446022 | Mary Harrington | Physical Therapist | 3320 Copper Hill Run, Fort Wayne, IN 46804 | 2018-05-09 |
| 1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
| 1194235408 | Mitchell Kory Meyer | Specialist/Technologist | 9125 Yellow Tree Ct, Fort Wayne, IN 46804 | 2017-10-02 |
| 1902324916 | Emily Rene Sagstetter | Specialist/Technologist | 6034 Liberty Glade Ct, Fort Wayne, IN 46804 | 2017-08-30 |
| Find all providers in zip 46804 | ||||
| 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 |
|---|---|---|---|---|
| 1982966255 | Kevin Harrington Ludwig | Dentist | 10211 Dupont Circle Dr W, Suite B, Fort Wayne, IN 46825-1622 | 2012-06-13 |
| 1619059557 | Timothy R Olinger | Dentist | 10211 Dupont Circle Drive West, Fort Wayne, IN 46825-1625 | 2006-10-19 |
| 1104859701 | Pediatric Dentistry Inc | Dentist | 7750 West Jefferson Blvd, Fort Wayne, IN 46804-4136 | 2006-07-08 |
| 1689185886 | Fort Wayne Pediatric Dentistry LLC | Dentist | 10211 Dupont Circle Dr W, Fort Wayne, IN 46825-1622 | 2017-10-16 |
| 1124127832 | James A Shupe Dds, Dentistry for Children, Inc | Dentist | 3030 Lake Ave, Suite 15, Fort Wayne, IN 46805-5428 | 2006-09-21 |
| 1013016823 | James A Shupe Jr. | Dentist | 3030 Lake Ave, Suite 15, Fort Wayne, IN 46805-5428 | 2006-09-21 |
| 1407860216 | Wayne Lee Dawes | Dentist | 7750 W Jefferson Blvd, Fort Wayne, IN 46804-4174 | 2006-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477186732 | Poplar Pediatric Dentistry LLC | Dentist | 6741 Lexington Cir, Zionsville, IN 46077-9164 | 2020-02-14 |
| 1265074710 | Hendricks Pediatric Dentistry, LLC | Dentist | 1557 Windview, Brownsburg, IN 46112-7641 | 2019-10-16 |
| 1760048748 | Kids Dentistree of In, LLC | Dentist | 1602 W Mcclain Ave, Scottsburg, IN 47170-1161 | 2019-05-15 |
| 1134691090 | Dentistry Just for Kids and Orthodontics, LLC | Dentist | 1107 Ohio St, Terre Haute, IN 47807-3817 | 2018-12-17 |
| 1588159339 | Kids Dentistree of In, LLC | Dentist | 7900 E Us Highway 36 Ste K, Avon, IN 46123-7791 | 2018-06-25 |
| 1285128512 | Schulten Pediatric Dentistry - New Albany LLC | Dentist | 4317 Charlestown Rd, New Albany, IN 47150-8506 | 2018-06-20 |
| 1255843116 | John A. Bozc, D.d.s. PC | Dentist | 520 W Navajo St, West Lafayette, IN 47906-1999 | 2017-11-01 |
| 1316463607 | Emhardt Pediatric Dentistry LLC | Dentist | 1818 N Riley Hwy Ste B, Shelbyville, IN 46176-8572 | 2017-08-17 |
| 1194245225 | Sara Gholam | Dentist | 1121 W Michigan St Rm 280b, Indianapolis, IN 46202 | 2017-06-20 |
| 1245788066 | Eric Ladd, D.d.s. | Dentist | 555 W Us Highway 30, Schererville, IN 46375-2650 | 2016-09-21 |
| Find all providers with the same taxonomy | ||||
| City | FORT WAYNE |
| Zip Code | 46804 |
Please comment or provide details below to improve the information on PEDIATRIC DENTAL ASSOCIATES PC.
| 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.