MISSOULA PEDIATRIC DENTISTRY, PLLC (NPI# 1578993531) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578993531 |
| Entity Type | Organization |
| Organization Name | MISSOULA PEDIATRIC DENTISTRY, PLLC |
| Practice Address |
3020 S Reserve St Suite D Missoula MT 59801-7652 |
| Practice Telephone | 4065417334 |
| Practice Fax Number | 4065417338 |
| Mailing Telephone | 4065417334 |
| Mailing Fax Number | 4065417338 |
| Enumeration Date | 2013-11-12 |
| Last Update Date | 2013-11-12 |
| Authorized Official Name | PAUL LEONARD TIEDE (BUSINESS MANAGER) |
| Authorized Official Telephone | 4065417334 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
MT2151 | MT | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | 1942483524 | 05 |
| Street Address |
3020 S RESERVE ST SUITE D |
| City | MISSOULA |
| State | MT |
| Zip Code | 59801-7652 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255620928 | Missoula Oral Surgery | Clinic/Center | 3020 S Reserve St, Suite C, Missoula, MT 59801-7644 | 2011-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629681010 | Time To Thrive Pllc | Social Worker | 1836 South Ave. West, Missoula, MT 59801 | 2020-08-26 |
| 1740815653 | Yuzo Fujiki | Specialist/Technologist | 210 N California St 104, Missoula, MT 59801 | 2020-03-11 |
| 1407346596 | Stepping Stones Counseling, Pllc | Counselor | 202 Brooks St Ste 300, Missoula, MT 59801 | 2018-05-14 |
| 1437668530 | Rejuve Care Clinic, Inc | Plastic Surgery | 715 Kensingten, Ste 1, Missoula, Missoula, MT 59801 | 2017-09-21 |
| 1619499555 | Beatrice Elise Powers | Specialist/Technologist | 410 B Stephens Ave, Missoula, MT 59801 | 2017-07-12 |
| 1770012197 | Hannah Lepiane | Massage Therapist | 1313 S. 4th W., Missoula, MT 59801 | 2017-06-08 |
| 1811420227 | Celeste Willis | Social Worker | 1055 W. Sussex, Missoula, MT 59801 | 2017-04-04 |
| 1073050498 | Rina Kasuga | Specialist/Technologist | 913 Rimini Ct, Missoula, MT 59801 | 2017-01-24 |
| 1043756919 | Heather Bartz | Specialist/Technologist | 831 Hastings Ave, Missoula, MT 59801 | 2017-01-16 |
| 1255874517 | Sarabeth Haddad | Social Worker | 1055 W Sussex Ave, Missoula, MT 59801 | 2016-11-18 |
| Find all providers in zip 59801 | ||||
| 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 |
|---|---|---|---|---|
| 1578081428 | 3 Rivers Pediatric Dentistry | Dentist | 225 Hastings Ave, Missoula, MT 59801-5951 | 2017-08-30 |
| 1558308221 | Susan Bon Tiede | Dentist | 3020 S Reserve St Ste D, Suite B, Missoula, MT 59801-7652 | 2006-06-01 |
| 1205183852 | Missoula Peditric Dentistry, P.C. | Dentist | 3020 S Reserve St Ste D, Missoula, MT 59801-7652 | 2012-08-13 |
| 1790939932 | Children's Dentistry of The Rockies | Dentist | 1009 S Reserve St, Missoula, MT 59801-3140 | 2008-11-14 |
| 1356549646 | April Marie Nelson Foster | Dentist | 3020 S Reserve St Ste D, Missoula, MT 59801-7652 | 2007-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124626262 | Havre Pediatric Dentistry | Dentist | 515 14th St W, Havre, MT 59501-5121 | 2020-10-12 |
| 1841839230 | Trailhead Pediatric Dentistry | Dentist | 513 Hilltop Rd Ste 5, Billings, MT 59105-2375 | 2020-01-02 |
| 1770051567 | Glasgow Pediatric Dentistry | Dentist | 90 Us Highway 2 E Ste A, Glasgow, MT 59230-2009 | 2018-11-09 |
| 1477911618 | Chad Cattron | Dentist | 155 Hutton Ranch Rd # 102, Kalispell, MT 59901-2133 | 2016-02-02 |
| 1720446289 | Clint Chlarson | Dentist | 3042 Golden Acres Dr, Billings, MT 59106-2254 | 2016-01-29 |
| 1346631249 | Tanner Douglas Bennion | Dentist | 2700 Grand Ave Ste B, Billings, MT 59102-2682 | 2015-02-12 |
| 1972921450 | Gabriel Dawson | Dentist | 795 Sunset Blvd Ste C, Kalispell, MT 59901-3610 | 2014-04-02 |
| 1457615494 | Emily Rockne | Dentist | 3116 Saddle Dr Ste 1, Helena, MT 59601-8645 | 2012-06-25 |
| 1821385915 | Justin Matthew Stevens | Dentist | 3980 Valley Commons Dr, Bozeman, MT 59718-5603 | 2011-07-08 |
| 1417244781 | Camron Shayn Buttars | Dentist | 1601 Zimmerman Trl Ste 1, Billings, MT 59102-7654 | 2011-07-07 |
| 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.