DR. KRISTEN CHARLENE PONICHTER (NPI# 1821304858) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1821304858 |
Entity Type | Individual |
Full Name | DR. KRISTEN CHARLENE PONICHTER |
Credential | DMD |
Practice Address |
7633 E Jefferson Ave Detroit MI 48214-3730 |
Mailing Address |
503 S Crooks Rd Clawson MI 48017-1816 |
Practice Telephone | (313) 652-1600 |
Mailing Telephone | 2484599525 |
Enumeration Date | 2010-08-27 |
Last Update Date | 2017-07-20 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
2901020315 | MI | Dental Providers |
Street Address |
7633 E JEFFERSON AVE |
City | DETROIT |
State | MI |
Zip Code | 48214-3730 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922097542 | Steven P Hadesman | Internal Medicine | 7633 E Jefferson Ave, Suite 290, Detroit, MI 48214-3730 | 2005-10-17 |
1336675727 | Nicholas Joseph Thomas | Student in an Organized Health Care Education/Training Program | 7633 E Jefferson Ave, Suite 70, Detroit, MI 48214-3730 | 2017-05-04 |
1629510482 | Dds-tapestry | Dentist | 7633 E Jefferson Ave, Ste 200, Detroit, MI 48214-3730 | 2016-11-10 |
1144677501 | Princess Elhosary | Dentist | 7633 E Jefferson Ave, Suite 70, Detroit, MI 48214-3730 | 2016-05-16 |
1427419688 | Ashley D'agostini | Student in an Organized Health Care Education/Training Program | 7633 E Jefferson Ave, Suite 70, Detroit, MI 48214-3730 | 2016-03-16 |
1912383928 | Dearborn Podiatry Clinic Pllc | Podiatrist | 7633 E Jefferson Ave, Suite 250, Detroit, MI 48214-3730 | 2015-08-03 |
1487037610 | Samantha Dubin | Student in an Organized Health Care Education/Training Program | 7633 E Jefferson Ave, Suite 70, Detroit, MI 48214-3730 | 2015-07-07 |
1023415288 | Bazzi Podiatry | Podiatrist | 7633 E Jefferson Ave, Suite 250, Detroit, MI 48214-3730 | 2014-12-03 |
1164829438 | David Scott Coviak | Dentist | 7633 E Jefferson Ave, Suite 70, Detroit, MI 48214-3730 | 2014-12-02 |
1124428198 | Matthew Cannavo | Dentist | 7633 E Jefferson Ave, Suite 70, Detroit, MI 48214-3730 | 2014-08-27 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376042325 | Tamara Wesley | Registered Nurse | 9000 E. Jefferson Apt 28-14, Detroit, MI 48214 | 2018-02-06 |
1720534381 | Birth Beautiful Detroit | Clinic/Center | 1086 Baldwin, Detroit, MI 48214 | 2016-09-01 |
1225402886 | Steven Doyle Whatley I | Counselor | 1423 Field Ave., Adult Well Being Services, Detroit, MI 48214 | 2015-11-19 |
1255587945 | Andrew Avery | Internal Medicine | 7733 East Jefferson Ave, Detroit, MI 48214 | 2008-08-13 |
1639330210 | Nicole Lashawn Greene | Specialist | 4533 St Clair St, Detroit, MI 48214 | 2008-06-17 |
1629299433 | Alan R Faber Jr. | Dentist | 8191 E Jefferson Ave, Detroit, MI 48214 | 2007-05-01 |
1518188598 | Mary F Bridges | Psychiatry & Neurology | 8120 East Jefferson #3l, Detroit, MI 48214 | 2007-05-01 |
1053439737 | Geraldine Etella Davis | Counselor | 3840 Fairview St., Detroit, MI 48214 | 2007-03-27 |
1639203482 | Detroit-macomb Hospital Corporation | Advanced Practice Midwife | 7815 E. Jefferson, Detroit, MI 48214 | 2007-03-15 |
1033275441 | Anesha Amor Rouse | Physical Therapy Assistant | 7633 E. Jefferson Ave, Suite 170, Detroit, MI 48214 | 2006-12-29 |
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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 |
---|---|---|---|---|
1669722856 | Richard Iain Tann | Dentist | 79 W Alexandrine St Fl 3, Detroit, MI 48201-2015 | 2012-09-14 |
1093846974 | Mona Rizk Ibrahim | Dentist | Detroit Health Dept. - Herman Kiefer Health Complex, 1151 Taylor Street, 7th Floor Pediatric Dental Clinic, Detroit, MI 48202-1732 | 2007-03-09 |
1801846985 | James Patrick Stenger | Dentist | 79 W Alexandrine St, 3rd Floor, Detroit, MI 48201-2015 | 2006-05-11 |
1104482439 | Childrens Dental Care of Detroit | Dentist | 430 Mack Ave, Detroit, MI 48201-2136 | 2019-05-13 |
1104307651 | Fahad Siddiqui | Dentist | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2018-08-23 |
1992165930 | Rehab Alabduljabbar | Dentist | 2700 Mlk Jr Blvd, Detroit, MI 48208-2576 | 2016-03-03 |
1851751150 | Thomas Veraldi, Dmd Residency and Hospital Practice, PC | Dentist | 79 W Alexandrine St, 3rd Flr, Detroit, MI 48201-2015 | 2016-02-29 |
1215215298 | Deliver Dental Solutions, Inc. | Dentist | 79 W Alexandrine St, 3rd Floor, Detroit, MI 48201-2015 | 2011-07-25 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033717558 | Discover Smiles Pediatric Dentistry | Dentist | 2277 Science Pkwy Ste 2, Okemos, MI 48864-2551 | 2020-10-16 |
1740898873 | Megan E Stowers Dds Ms Plc | Dentist | 7459 Middlebelt Rd Ste 1, West Bloomfield, MI 48322-4184 | 2020-07-15 |
1447884069 | Jocelyn M. Robelli Dds, Ms, Pllc | Dentist | 18245 E 10 Mile Rd Ste 110, Roseville, MI 48066-5807 | 2020-02-24 |
1457914038 | Mitten Kids Dentistry Caledonia Plc | Dentist | 6477 Cherry Meadow Dr Se Ste 4, Caledonia, MI 49316-7351 | 2019-04-18 |
1780143982 | Childrens Dental Specialists of Hazel Park Pllc | Dentist | 22241 John R Rd, Hazel Park, MI 48030-1716 | 2019-03-18 |
1487128120 | Dental Group Associates PC | Dentist | 4505 Cascade Rd Se # B, Grand Rapids, MI 49546-8381 | 2019-01-16 |
1184194433 | Pediatric Dental Specialists of West Michigan | Dentist | 2155 E Paris Ave Se Ste 120, Grand Rapids, MI 49546-6142 | 2018-11-29 |
1811465990 | Kingma Pediatric Dentistry Pllc | Dentist | 1179 E Paris Ave Se Ste 130, Grand Rapids, MI 49546-3682 | 2018-11-07 |
1407322548 | Great Lakes Bay Pediatric Dentistry, Plc | Dentist | 5605 Colony Dr N Ste 2, Saginaw, MI 48638-7187 | 2018-10-16 |
1063987725 | Little Red Pediatric Dentistry, Plc | Dentist | 12723 N Bellwood Dr Ste 20, Holland, MI 49424-7275 | 2018-10-09 |
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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.