KIDS DENTISTREE OF IN, LLC (NPI# 1588159339) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588159339 |
| Entity Type | Organization |
| Organization Name | KIDS DENTISTREE OF IN, LLC |
| Other Organization Name | KIDS DENTISTREE - AVON |
| Practice Address |
7900 E Us Highway 36 Ste K Avon IN 46123-7791 |
| Mailing Address |
Po Box 437169 Louisville KY 40253-7169 |
| Practice Telephone | 3175610090 |
| Practice Fax Number | 3175160345 |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2020-01-06 |
| Authorized Official Name | STEPHEN JAMES (CFO) |
| Authorized Official Telephone | 5022548500 |
| 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 |
|---|---|
| Kids Dentistree - Avon | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 8101 E Us Highway 36 Ste A, Avon, IN 461238082 | 3175610090 | 3175343428 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760048748 | Kids Dentistree of In, LLC | Dentist | 1602 W Mcclain Ave, Scottsburg, IN 47170-1161 | 2019-05-15 |
| 1699260984 | Kids Dentistree of In, LLC | Dentist | 11801 Brinley Ave Ste 100, Louisville, KY 40243-3006 | 2018-06-28 |
| 1922593821 | Kids Dentistree of In, LLC | Dentist | 3120 Blackiston Mill Rd, New Albany, IN 47150 | 2018-06-25 |
| Street Address |
7900 E US HIGHWAY 36 STE K |
| City | AVON |
| State | IN |
| Zip Code | 46123-7791 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669018669 | Dienye Williams | Pharmacist | 108 North Sr 267, Avon, IN 46123 | 2019-11-25 |
| 1992353817 | Debra Blackwell | Technician | 8198 Montage Ave, Apt 104, Avon, IN 46123 | 2019-09-04 |
| 1932675766 | Blake Ponist | Occupational Therapist | 10940 E U S Highway 36, Rockville Rd, Avon, IN 46123 | 2018-10-19 |
| 1396238150 | Sarah Sweany | Dietitian, Registered | Iu Health West Cancer Center, 1111 North Ronald Reagen Pkwy Suite B1600, Avon, IN 46123 | 2018-06-07 |
| 1124516257 | Sheree Itza | Counselor | 6655 E Us Highway 36 Ste 100, Avon, IN 46123 | 2018-04-24 |
| 1255860607 | Jonathan Lambert | Dentist | 110 N Avon Ave B, Avon, IN 46123 | 2017-06-08 |
| 1023546629 | 10439 E Us Highway 36 Dental, LLC | Dentist | 10439 E Us Highway 36, Avon, IN 46123 | 2017-05-25 |
| 1902330756 | Melissa Wheatley | Occupational Therapy Assistant | 6294 Forest View Court, Avon, IN 46123 | 2017-04-19 |
| 1932555844 | Gal Marcan | Family Medicine | 1351 Ronald Reagan Pkwy Ste B, Avon, IN 46123 | 2016-05-10 |
| 1962871301 | Annette Joelene Oechsle | Health Educator | 1820 South County Road 525 East, Avon, IN 46123 | 2015-09-16 |
| Find all providers in zip 46123 | ||||
| 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 |
|---|---|---|---|---|
| 1336572791 | Todd Bernard | Dentist | 37701 Colorado Ave Ste E, Avon, OH 44011 | 2013-08-20 |
| 1982968848 | Staci Robinson Allen | Dentist | 44 Dale Rd Ste 305, Avon, CT 06001-4351 | 2012-06-26 |
| 1225209745 | Abha Pandey | Dentist | 110 N State Road 267, Avon, IN 46123-8475 | 2008-03-13 |
| 1922168566 | Jason Christopher Barb | Dentist | 37701 Colorado Avenue, Suite E, Avon, OH 44011 | 2006-12-12 |
| 1447226998 | Kidsmile, Inc. - John M. Venzel, D.m.d. | Dentist | 37701 Colorado Ave, Suite E, Avon, OH 44011-2840 | 2006-02-24 |
| 1801887633 | Ira M Greene | Dentist | 34 Dale Rd, Avon, CT 06001-3659 | 2005-11-01 |
| 1033562210 | Pediatric Dental Center of Avon, LLC | Dentist | 44 Dale Rd Ste 305, Avon, CT 06001-4351 | 2016-07-22 |
| 1528405735 | Katherine Blair Bumgardner | Dentist | 8101 E Us Highway 36 Ste A, Avon, IN 46123-8082 | 2013-05-29 |
| 1992011548 | Kidsmile, Inc. - Jason C. Barb, Dds, Inc. | Dentist | 37701 Colorado Ave, Suite E, Avon, OH 44011-2840 | 2010-08-20 |
| 1598931610 | John Matthew Venzel | Dentist | 37701 Colorado Ave, Suite E, Avon, OH 44011 | 2008-05-08 |
| Find all providers in AVON | ||||
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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.