GEORGETOWN PEDIATRIC DENTISTRY, LLC (NPI# 1851567499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1851567499 |
Entity Type | Organization |
Organization Name | GEORGETOWN PEDIATRIC DENTISTRY, LLC |
Other Organization Name | COVE PEDIATRIC DENTISTRY & ORTHODONTICS |
Practice Address |
4507 Williams Drive Georgetown TX 78633 |
Mailing Address |
4507 Williams Dr Georgetown TX 78633 |
Practice Telephone | 5128694100 |
Mailing Telephone | 5128694100 |
Enumeration Date | 2008-05-04 |
Last Update Date | 2014-04-04 |
Authorized Official Name | DR. KENNETH SEELY HAVARD (PARTNER/DENTIST) |
Authorized Official Telephone | 5128180232 |
Authorized Official Credential | D.D.S. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
16755 | TX | Dental Providers |
N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
22754 | TX | Dental Providers |
Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
23759 | TX | Dental Providers |
Other Name | Type Code |
---|---|
Cove Pediatric Dentistry & Orthodontics | Doing Business As Name - Organization |
Street Address |
4507 WILLIAMS DRIVE |
City | GEORGETOWN |
State | TX |
Zip Code | 78633 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568098937 | Medsur One Telemedicine LLC | Nurse Practitioner | 110 Eisenhower Court (administrative Office Location), 1309 Coffeen Ave Ste 1200 Sheridan Wy 82801, Georgetown, TX 78633 | 2020-03-18 |
1467946384 | Majestic Healthcare, Pllc | Nurse Practitioner | 110 Eisenhower Ct, Georgetown, TX 78633 | 2018-06-15 |
1912419649 | Randalls Food & Drugs Lp | Durable Medical Equipment & Medical Supplies | 5721 Williams Dr, Georgetown, TX 78633 | 2017-11-03 |
1255783510 | Peter James Mcgrath | Physical Therapist | 4749 Williams Drive, Suite 335, Georgetown, TX 78633 | 2016-07-11 |
1316357346 | Cody Ryon Gomez | Internal Medicine | 3201 South Austin Ave, Suite 205, Georgetown, TX 78633 | 2014-04-29 |
1902130701 | Don Wayne Berry | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 624 Rio Grand Loop, Georgetown, TX 78633 | 2009-09-25 |
1215035845 | Saramma George | Family Medicine | 105 Wildwood Drive, Suite 105, Georgetown, TX 78633 | 2006-09-20 |
1104834258 | Mobile Cr Imaging, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 4749 Williams Dr, Georgetown, TX 78633 | 2006-08-04 |
1619997350 | Kathryn E Holland | Counselor | 603 Chambers Creek Ct, Georgetown, TX 78633 | 2006-07-19 |
1417404153 | Ochna Health | Clinic/Center | 4749 Williams Dr, Suite 304, Georgetown, TX 78633 | 2016-09-09 |
Find all providers in zip 78633 |
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 |
---|---|---|---|---|
1366613978 | Travis Reed Hildebrand | Dentist | 4402 Williams Dr, Ste 106, Georgetown, TX 78628-1341 | 2008-03-22 |
1447331509 | Pediatric Dentistry of Georgetown, Pllc | Dentist | 101 Darby Dr Ste 101, Georgetown, KY 40324-8715 | 2006-10-17 |
1396835575 | Hamid Yazdi | Dentist | 9415 W State Highway 29, Georgetown, TX 78628-6914 | 2006-10-16 |
1497386049 | Kids Dentistree of Ky LLC | Dentist | 1508 Oxford Dr, Georgetown, KY 40324-9266 | 2020-02-03 |
1184909814 | Liberty Hill Pediatric Dentistry, Pa | Dentist | 9415 W State Highway 29, Georgetown, TX 78628-6914 | 2011-10-13 |
1801060660 | Kelly M. Gonzales, Dds, PC | Dentist | 1103 Rivery Blvd, Ste 140, Georgetown, TX 78628-3034 | 2008-04-14 |
1588836183 | Kenneth Seely Havard | Dentist | 4402 Williams Dr, Suite 106, Georgetown, TX 78628-1341 | 2008-03-24 |
1417128687 | Kelly Marie Gonzales | Dentist | 1103 Rivery Blvd, Ste. 140, Georgetown, TX 78628-3034 | 2008-03-17 |
1083807945 | Dentistry for Children | Dentist | 205 Champion Way, Suite 9, Georgetown, KY 40324-8862 | 2007-08-23 |
1588788970 | Alison Damarodas Campbell | Dentist | 1103 Rivery Blvd, Ste 140, Georgetown, TX 78628-3034 | 2007-03-19 |
Find all providers in GEORGETOWN |
City | GEORGETOWN |
Zip Code | 78633 |
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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.