KOOL KOALA PEDIATRIC & ADOLESCENT DENTISTRY LLC (NPI# 1538798475) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538798475 |
| Entity Type | Organization |
| Organization Name | KOOL KOALA PEDIATRIC & ADOLESCENT DENTISTRY LLC |
| Practice Address |
1126 Pulaski Hwy Bear DE 19701-1306 |
| Mailing Address |
103 Curtis Ct Swedesboro NJ 08085-3223 |
| Practice Telephone | 8562300924 |
| Mailing Telephone | 8562300924 |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2020-04-03 |
| Authorized Official Name | DR. FREDERICK BALLARD (OWNER/OPERATOR) |
| Authorized Official Telephone | 8562300924 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Street Address |
1126 PULASKI HWY |
| City | BEAR |
| State | DE |
| Zip Code | 19701-1306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174165427 | Delaware Dental Solutions LLC | Dentist | 131 Becks Woods Dr., Bear, DE 19701 | 2019-10-08 |
| 1174004345 | The Life Center Complex, Inc. | Clinic/Center | 4050 Wrangle Hill Rd, Bear, DE 19701 | 2018-08-27 |
| 1124513270 | Shanila Shagufta | Psychiatry & Neurology | 434 Roger Chaffee Sq., Bear, DE 19701 | 2018-06-29 |
| 1932614393 | Steps Center LLC | Home Health | 14 S Saint George Ter, Bear, DE 19701 | 2017-12-07 |
| 1467978205 | Ijn Health Systems, LLC | Home Health | 603 Parkman Court, Bear, DE 19701 | 2017-08-14 |
| 1992226922 | Sharon Thebe | Nurse Practitioner | 30 Printz Drive, Bear, DE 19701 | 2017-06-29 |
| 1003286287 | Prosperous, LLC | Specialist | 131 Becks Woods Drive, Bear, MD 19701 | 2015-10-01 |
| 1881075695 | Yvette Pendleton | Technician, Pathology | 30 Lotus Circle N, Bear, DE 19701 | 2015-06-17 |
| 1639574692 | Nicole Sult | Counselor | 516 Daniels Ct, Bear, DE 19701 | 2014-11-01 |
| 1528498797 | Advanced Behavior Treatment, LLC | Community/Behavioral Health | 9 Willhelen Ct, Bear, DE 19701 | 2013-11-25 |
| Find all providers in zip 19701 | ||||
| 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 |
|---|---|---|---|---|
| 1063971745 | Delaware Pediatric Dentistry | Dentist | 625 N Dupont Blvd, Milford, DE 19963-1099 | 2019-03-13 |
| 1083189609 | Children's Dental Health of Delaware, LLC | Dentist | 3301 Lancaster Pike # 3e3f, Wilmington, DE 19805-1436 | 2018-10-10 |
| 1427567379 | Mid-atlantic Dental Partners Delaware II Professional Associates | Dentist | 4201 Miller Rd, Wilmington, DE 19802-1914 | 2017-09-22 |
| 1003109877 | Jill Laurie Garrido | Dentist | 2000 Foulk Rd Ste C, Wilmington, DE 19810-3642 | 2011-05-26 |
| 1609086479 | Mary Katherine Matthews | Dentist | 451 Hockessin Cors, Hockessin, DE 19707-9586 | 2007-05-23 |
| 1801916804 | Richard Michael Quinn | Dentist | 1380 S State St, Dover, DE 19901-4946 | 2007-03-31 |
| 1316095904 | B.b. Roseman Dmd, Md L.b Jacobs Dmd Pa | Dentist | 708 Foulk Rd, Wilmington, DE 19803-3734 | 2007-01-08 |
| 1053497818 | Lynn Marie Collins | Dentist | 38 Peoples Plz, Newark, DE 19702-4727 | 2006-10-27 |
| 1134154297 | Francis Jerome Vaughan | Dentist | 613 Philadelphia Pike, Wilmington, DE 19809-2550 | 2006-07-11 |
| 1346248895 | Lawrence A Louie | Dentist | 250 Beiser Blvd, Suite 101, Dover, DE 19904-7790 | 2005-07-08 |
| 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.