SPRINGFIELD PEDIATRIC DENTISTRY (NPI# 1497210546) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497210546 |
| Entity Type | Organization |
| Organization Name | SPRINGFIELD PEDIATRIC DENTISTRY |
| Other Organization Name | SIRISHA GOVINDAIAH DDS, PLLC |
| Practice Address |
1224 Centre West Dr Springfield IL 62704-2184 |
| Mailing Address |
10900 Fox Crst San Antonio TX 78233-7249 |
| Practice Telephone | 2176660098 |
| Mailing Telephone | 2176660098 |
| Enumeration Date | 2019-02-04 |
| Last Update Date | 2019-02-04 |
| Authorized Official Name | DR. SIRISHA GOVINDAIAH (DENTIST/PRESIDENT) |
| Authorized Official Telephone | 2176660098 |
| Authorized Official Credential | BDS, MPH, DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Sirisha Govindaiah DDS, PLLC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013409887 | Springfield Pediatric Dentistry | Dentist | 3130 Tom Austin Hwy Ste B, Springfield, TN 37172 | 2018-06-06 |
| 1811333792 | Springfield Pediatric Dentistry | Dentist | 2200 Olympic Street, Springfield, OH 45503 | 2013-05-17 |
| Street Address |
1224 CENTRE WEST DR |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62704-2184 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871681882 | Thomas Paul Ford | Dentist | 1224 Centre West Dr, Suite 100, Springfield, IL 62704-2184 | 2006-10-11 |
| 1043308067 | George Patrick Conour | Dentist | 1224 Centre West Dr, Suite100, Springfield, IL 62704-2184 | 2006-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902394901 | Hillary Haaker | Occupational Therapist | 2035 W Iles, Suite C, Springfield, ID 62704 | 2018-04-25 |
| 1871095364 | Edward Doyle Slifer Sr. | Pathology | 2117 Greenside Drive, Spring Field, IL 62704 | 2018-03-01 |
| 1598263345 | Santarelli & Feller Dental Group | Dentist | 1140 Rickard Road, Suite B, Springfield, IL 62704 | 2018-01-26 |
| 1447774757 | Lisa Ann Rogers | Developmental Therapist | 2101 Lexington Dr, Apt 3, Springfield, IL 62704 | 2017-07-28 |
| 1730611286 | Mindi Rowe | Occupational Therapist | 2508 County Rd 4 1/2 E, Springfield, IL 62704 | 2017-04-03 |
| 1366992208 | Jayme Jordan | Contractor | 2409 Westchester Blvd, Springfield, IL 62704 | 2016-10-04 |
| 1154793974 | Dina Payne | Social Worker | 917 Clocktower Drive, Suite 600, Springfield, IL 62704 | 2015-10-21 |
| 1770959819 | James R Reynolds | Hearing Instrument Specialist | 2347 W Monroe St, Springfield, IL 62704 | 2015-08-12 |
| 1336576495 | Emily Jane Dungey | Counselor | 920 S Spring St Ste 1300, Springfield, IL 62704 | 2013-10-03 |
| 1942552161 | Jeannie Marie Hundley | Specialist/Technologist, Other | 2921 Monvale Drive, Springfield, IL 62704 | 2012-10-11 |
| Find all providers in zip 62704 | ||||
| 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 |
|---|---|---|---|---|
| 1013409887 | Springfield Pediatric Dentistry | Dentist | 3130 Tom Austin Hwy Ste B, Springfield, TN 37172 | 2018-06-06 |
| 1770999658 | Shehzad Muhammad Sajid | Dentist | 7200 Jillspring Ct, Springfield, VA 22152 | 2014-07-11 |
| 1265858021 | John Han D.d.s., P.C. | Dentist | 6120 Brandon Ave Ste 114, Springfield, VA 22150-2504 | 2014-03-17 |
| 1174804280 | Nahee Williams Mcdonald Dds PC | Dentist | 7841f Rolling Rd, Springfield, VA 22153-2821 | 2011-09-01 |
| 1619177854 | Nahee Williams Mcdonald | Dentist | 7841 Rolling Road, Suite F, Springfield, VA 22153 | 2007-07-24 |
| 1346457983 | Scott H Leaf | Dentist | 7841 Rolling Rd # F, Springfield, VA 22153-2821 | 2007-05-16 |
| 1225243173 | Anne Tran Nghiem | Dentist | 200 Birnie Ave, No Tooth Left Behind Dental Clinic, Springfield, MA 01107-1102 | 2007-05-14 |
| 1730243296 | Susan M Maurer | Dentist | 3020 Happy Landing Dr, Springfield, IL 62711-6259 | 2006-12-20 |
| 1568533727 | Springfield Smiles Youth Dentistry, LLC | Dentist | 376 Cooley St, Springfield, MA 01128-1144 | 2006-11-10 |
| 1427139872 | Joseph Michael Pruitt | Dentist | 1324 E Montclair St, Springfield, MO 65804-4245 | 2006-10-18 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62704 |
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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.