GREAT FALLS PEDIATRIC DENTISTRY, LLC (NPI# 1922479047) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922479047 |
| Entity Type | Organization |
| Organization Name | GREAT FALLS PEDIATRIC DENTISTRY, LLC |
| Practice Address |
1717 4th St S Great Falls MT 59405-4133 |
| Practice Telephone | 4064490189 |
| Practice Fax Number | 4064497237 |
| Mailing Telephone | 4064490189 |
| Mailing Fax Number | 4064497237 |
| Enumeration Date | 2015-10-15 |
| Last Update Date | 2015-10-15 |
| Authorized Official Name | KEVIN L RENCHER (DENTIST) |
| Authorized Official Telephone | 4064490189 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
2145 | MT | Dental Providers |
| Street Address |
1717 4TH ST S |
| City | GREAT FALLS |
| State | MT |
| Zip Code | 59405-4133 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336205632 | Alexander C Archibald | Optometrist | 1717 4th St S, Great Falls, MT 59405-4133 | 2006-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902446180 | Reilly Kunz | Physical Therapist | 2621 15th Ave South, Great Falls, MT 59405 | 2020-01-15 |
| 1336617224 | Brandi Noel Sauer | Behavior Technician | 1601 2nd Ave North Suite 518, Great Falls, MT 59405 | 2018-11-08 |
| 1982103446 | Traci Raines Aprn Pllc | Nurse Practitioner | 120 Marillyn Dr, Great Falls, MT 59405 | 2018-02-09 |
| 1003332818 | Great Falls Health Supplies | Durable Medical Equipment & Medical Supplies | 1720 10th Ave., South, Suite 4-151, Great Falls, MT 59405 | 2017-08-15 |
| 1518489426 | Jessica Lynn Keller | Specialist/Technologist | 720 46th Street South, Great Falls, MT 59405 | 2017-07-12 |
| 1235678475 | Vanessa Claudia Hernandez | Occupational Therapist | 2621 15 Ave So, Great Falls, MT 59405 | 2017-02-21 |
| 1871039339 | Morgan Laux Olsen | Specialist/Technologist | 1301 20th St S, Great Falls, MT 59405 | 2017-01-09 |
| 1558807198 | Greg Robert Lipton | Occupational Therapist | 2621 15th Ave So, Great Falls, MT 59405 | 2017-01-06 |
| 1386180925 | Jessica Lee Krahn | Physical Therapist | 2621 15th Ave So., Great Falls, MT 59405 | 2017-01-06 |
| 1811430150 | Juli Brandvold | Massage Therapist | 2400 4th Ave S., Great Falls, MT 59405 | 2016-11-18 |
| Find all providers in zip 59405 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1578081428 | 3 Rivers Pediatric Dentistry | Dentist | 225 Hastings Ave, Missoula, MT 59801-5951 | 2017-08-30 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | GREAT FALLS |
| Zip Code | 59405 |
Please comment or provide details below to improve the information on GREAT FALLS PEDIATRIC DENTISTRY, LLC.
| 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.