DR. MATTHEW NICHOLSON DAMIN (NPI# 1538505615) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538505615 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW NICHOLSON DAMIN |
| Credential | D.M.D. |
| Practice Address |
1830 Destiny Ln Suite 119 Bowling Green KY 42104-1087 |
| Practice Telephone | 2703939925 |
| Practice Fax Number | 2703939928 |
| Mailing Telephone | 2703939925 |
| Mailing Fax Number | 2703939928 |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2015-11-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
9573 | KY | Dental Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1830 DESTINY LN SUITE 119 |
| City | BOWLING GREEN |
| State | KY |
| Zip Code | 42104-1087 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720081417 | Richard Young | Podiatrist | 1830 Destiny Ln, Suite 110, Bowling Green, KY 42104 | 2005-05-27 |
| 1063965242 | Life Abundant Center | Social Worker | 1830 Destiny Ln, Suite105, Bowling Green, KY 42104-1087 | 2016-07-25 |
| 1992195325 | Amanda Portman | Social Worker | 1830 Destiny Ln, Suite 112, Bowling Green, KY 42104-1087 | 2015-01-22 |
| 1013344084 | Restoration Counseling | Community/Behavioral Health | 1830 Destiny Ln, Bowling Green, KY 42104-1087 | 2013-10-04 |
| 1497030928 | Destiny Adult, Child & Family Services LLC | Community/Behavioral Health | 1830 Destiny Ln, Suite 112, Bowling Green, KY 42104-1087 | 2011-10-16 |
| 1043503022 | Carolyn Kates-glass | Social Worker | 1830 Destiny Ln, Suite 112, Bowling Green, KY 42104-1087 | 2011-05-24 |
| 1023257607 | Lisa Rae Rice | Counselor | 1830 Destiny Ln, Suite 107, Bowling Green, KY 42104-1087 | 2009-02-05 |
| 1154569614 | Lucille Lee Mcmichael | Social Worker | 1830 Destiny Ln, Suite 112, Bowling Green, KY 42104-1087 | 2009-01-21 |
| 1609079847 | Jacqueline Peterson | Marriage & Family Therapist | 1830 Destiny Ln, Suite 107, Bowling Green, KY 42104-1087 | 2007-06-06 |
| 1023229374 | Kelli Alexander Barbee | Dentist | 1830 Destiny Ln, Suite 119, Bowling Green, KY 42104-1087 | 2007-05-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043822042 | Ashley Marie Sterchi | Speech-Language Pathologist | The Kid Spot Center, 944 Fields Dr. #102, Bowling Green, KY 42104 | 2020-08-20 |
| 1093339111 | Rachel Marie Held | Specialist/Technologist | 886c Lynnwood Way, Apt. #7, Bowling Green, KY 42104 | 2020-06-04 |
| 1043846769 | C D S 10 Pharmacy LLC | Pharmacy | 1308 Ashley Circle, Bowling Green, KY 42104 | 2020-03-13 |
| 1073075792 | Applegate Health Services, Inc | Clinic/Center | 5966 Scottsville Road Unit 7, Bowling Green, KY 42104 | 2019-04-02 |
| 1487122099 | Candice Spencer | Specialist/Technologist, Other | 1945 Scottsville Rd B2 Pmb 397, Bowling Green, KY 42104 | 2018-11-13 |
| 1053819904 | Cumberland Foot and Ankle Centers | Orthopaedic Surgery | 1850 Westen Street, Bowling Green, KY 42104 | 2018-01-25 |
| 1841731494 | Olivia Catherine Sanders | Speech-Language Pathologist | 954 Aristides Dr, Bowling Green, KY 42104 | 2017-03-15 |
| 1376901488 | Trung Trinh | Pharmacist | 1530 Campbell Lane, Bowling Green, KY 42104 | 2016-02-03 |
| 1225409121 | Adam Wesley Baird | Optometrist | 760 Campbell Lane, Suite 120, Bowling Green, KY 42104 | 2015-10-18 |
| 1851797898 | Michelle Leigh King | Speech-Language Pathologist | 829 Mandarin Ave., Bowling Green, KY 42104 | 2014-11-18 |
| Find all providers in zip 42104 | ||||
| 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 |
| 1477611333 | Bowling Green Pediatric Dental Group Inc | Dentist | 1221 Ridgewood Drive, Suite B, Bowling Green, OH 43402-2667 | 2006-12-04 |
| 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 |
| 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 | 42104 |
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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.