WISE DENTISTRY FOR KIDS, PSC (NPI# 1790075166) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790075166 |
| Entity Type | Organization |
| Organization Name | WISE DENTISTRY FOR KIDS, PSC |
| Practice Address |
105 Medical Park Dr Suite 1 Campbellsville KY 42718-9622 |
| Mailing Address |
105 Medical Park Drive Suite 1 Campbellsville KY 42718 |
| Practice Telephone | 2704691403 |
| Practice Fax Number | 2704691405 |
| Mailing Telephone | 2704691403 |
| Mailing Fax Number | 2704691405 |
| Enumeration Date | 2011-04-19 |
| Last Update Date | 2011-04-19 |
| Authorized Official Name | DR. HEATHER WISE (OWNER/DENTIST) |
| Authorized Official Telephone | 2704691403 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
8254 | KY | Dental Providers |
| Street Address |
105 MEDICAL PARK DR SUITE 1 |
| City | CAMPBELLSVILLE |
| State | KY |
| Zip Code | 42718-9622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053439554 | Heather Hood Wise | Dentist | 105 Medical Park Dr, Suite #1, Campbellsville, KY 42718-9622 | 2007-03-26 |
| 1891316659 | Arrow Dental Pllc | Clinic/Center | 105 Medical Park Dr, Campbellsville, KY 42718-9622 | 2020-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619417763 | Heather Hastings | Dentist | 2065 Meadow Creek Rd, Campbellsville, KY 42718 | 2017-03-07 |
| 1487101804 | Amanda Rose Shepperd | Nurse Practitioner | 1846-1856 Old Lebanon Rd, Campbellsville, KY 42718 | 2016-09-01 |
| 1841660305 | Forefront Dermatology, S.c. | Dermatology | 105 Medical Park Dr Ste 1, Campbellsville, KY 42718 | 2015-09-28 |
| 1154790616 | Viktoria Krell | Counselor | 3020 Old Lebanon Road, Campbellsville, KY 42718 | 2015-09-15 |
| 1679977649 | Joy Trotter | Occupational Therapist | 121a Casey Street, Campbellsville, KY 42718 | 2014-10-20 |
| 1083022727 | Taylor Regional Medical Group, LLC | Physical Therapist | 73 Kingswood Dr Ste B, Campbellsville, KY 42718 | 2014-07-25 |
| 1235574831 | Rachael Maia Yates | Clinical Neuropsychologist | 50 Gene Cash Road, Campbellsville, KY 42718 | 2013-05-08 |
| 1255536579 | Elizabethtown Physical Therapy Psc | Clinic/Center | 315 East Broadway, Campbellsville, KY 42718 | 2007-06-18 |
| 1508900283 | Lake Cumberland District Health Department | Public Health or Welfare | 1880 N Bypass Road, Campbellsville, KY 42718 | 2007-02-16 |
| 1871639005 | Joseph William Segree | Optometrist | 725 Campbellsville Bypass, Campbellsville, KY 42718 | 2007-01-29 |
| Find all providers in zip 42718 | ||||
| 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 |
|---|---|---|---|---|
| 1518599802 | Derby City Pediatric Dentistry, Pllc | Dentist | 2120 High Wickham Pl Ste 103, Louisville, KY 40245-5903 | 2020-02-05 |
| 1588204655 | Kids Dentistree of Ky LLC | Dentist | 8727 Old Bardstown Rd, Louisville, KY 40291-4490 | 2020-01-07 |
| 1033775374 | Alex Mayes Young Dmd Pllc | Dentist | 7400 Us 42, Florence, KY 41042-1906 | 2019-05-13 |
| 1285299149 | Modern Kids Dentistry of Elizabethtown, Pllc | Dentist | 151 Drexler Cir # A, Elizabethtown, KY 42701-7843 | 2019-05-07 |
| 1780141580 | Morgan Marie Nowery | Dentist | 134 Gillette Ave, Louisville, KY 40214-1914 | 2019-02-27 |
| 1578030995 | Huda Hussain Alkuhl | Dentist | 501 S Preston St Fl 3, Louisville, KY 40202-1701 | 2018-10-24 |
| 1073099792 | Lake Cumberland Pediatric Dentistry | Dentist | 100 Hardin Ln Ste A, Somerset, KY 42503-3812 | 2018-07-16 |
| 1376032557 | Devon Cooper | Dentist | 5495 N Bend Rd Ste 102, Burlington, KY 41005-9378 | 2018-05-03 |
| 1609363795 | Alexandria Gene Maxson | Dentist | 1275 Hallwood Dr, Morehead, KY 40351-7370 | 2018-04-16 |
| 1831606094 | Djr2 Professional Limited Liability Company | Dentist | 303 S 4th St Ste 201, Danville, KY 40422-2091 | 2018-01-09 |
| Find all providers with the same taxonomy | ||||
| City | CAMPBELLSVILLE |
| Zip Code | 42718 |
Please comment or provide details below to improve the information on WISE DENTISTRY FOR KIDS, PSC.
| 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.