SUMMIT PEDIATRIC DENTISTRY (NPI# 1053848374) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053848374 |
| Entity Type | Organization |
| Organization Name | SUMMIT PEDIATRIC DENTISTRY |
| Practice Address |
24 Nw Chipman Rd Ste B Lees Summit MO 64063-1929 |
| Practice Telephone | (816) 256-0073 |
| Mailing Telephone | 8162560073 |
| Enumeration Date | 2017-05-17 |
| Last Update Date | 2017-05-17 |
| Authorized Official Name | MONCY MATHEW (OWNER/DENTIST) |
| Authorized Official Telephone | 8162560073 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
2006037222 | MO | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1841474293 | 05 |
| Street Address |
24 NW CHIPMAN RD STE B |
| City | LEES SUMMIT |
| State | MO |
| Zip Code | 64063-1929 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649895533 | Ian Christopher Fekete | Student in an Organized Health Care Education/Training Program | Lee's Summit Medical Center, 2100 Se Blue Pkwy, Lee's Summit, MO 64063 | 2020-06-16 |
| 1083268403 | Rachelle Colyer | Physical Therapist | 298 Sw Blue Pkwy, Lee's Summit, MO 64063 | 2019-07-25 |
| 1326504200 | Brenda Michelle Brown | Physical Therapist | 2160 Se Blue Parkway Addington Place, 2160 Seblue Parkway, Lee's Summit, MO 64063 | 2019-02-15 |
| 1528545068 | Bayada Home Health Care, Inc. | Home Health | 600 Sw Jefferson St Ste 101, Lees Summit, MO 64063 | 2018-07-27 |
| 1972089118 | Summit Integrative Dental (bromley, D.d.s. and Broyles, D.d.s.), P.C. | Dentist | 688 Se Bayberry Lane, Suite 101, Lee's Summit, MO 64063 | 2018-07-11 |
| 1104327576 | Molly Moore Mcgraw Davidson | Nurse Practitioner | 2000 Se Blue Pkwy Ste 270a, Lees Summit, MO 64063 | 2018-02-21 |
| 1821507591 | Joshua Greenwell | Chiropractor | 1634 Se Blue Pkwy, Lee's Summit, MO 64063 | 2017-09-26 |
| 1457870651 | Tlc Home Healthcare Consulting Inc | Registered Nurse | 109 Sw Madison St, Lee's Summit, MO 64063 | 2017-09-19 |
| 1053834622 | Kristin E Schwartz | Advanced Practice Midwife | 2000 Se Blue Pkwy Ste 220, Lees Summit, MO 64063 | 2017-07-25 |
| 1316493828 | Laura Ballantyne | Speech-Language Pathologist | 600 Se Miller St, Lees Summit, MO 64063 | 2016-08-26 |
| Find all providers in zip 64063 | ||||
| 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 |
|---|---|---|---|---|
| 1306829080 | Glynn Stephen Spencer Jr. | Dentist | 301 Ne Mulberry St, Suite #201, Lees Summit, MO 64086-5818 | 2005-11-27 |
| 1679880124 | Spencer and Spencer Pediatric Dentistry, Dds, PC | Dentist | 301 Ne Mulberry St, Suite #201, Lees Summit, MO 64086-5818 | 2010-09-04 |
| 1972587624 | Jodie L Spencer | Dentist | 301 Ne Mulberry St, Suite 201, Lees Summit, MO 64086-5818 | 2005-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366068009 | Hometown Pediatric Dentistry LLC | Dentist | 301 S Platte Clay Way Ste A, Kearney, MO 64060-8826 | 2020-06-18 |
| 1710539937 | M. Pratt, Dds, LLC | Dentist | 11709 Old Ballas Rd Ste 200, Saint Louis, MO 63141-7029 | 2019-07-09 |
| 1619471356 | Allison W Buford | Dentist | 2325 Dougherty Ferry Rd Ste 200, Saint Louis, MO 63122-3356 | 2018-03-19 |
| 1972014504 | Rock Dental Missouri LLC | Dentist | 181 N Kentucky Ave Ste 300, West Plains, MO 65775-2092 | 2017-10-23 |
| 1811408479 | Waldo Pediatric Dentistry | Dentist | 8043 Wornall Rd Ste 202, Kansas City, MO 64114-5822 | 2017-10-22 |
| 1437668126 | Como Pediatric Dentistry LLC | Dentist | 1316 Old 63 S Ste 201, Columbia, MO 65201-6092 | 2017-09-25 |
| 1043741309 | Unruh Pediatric Dentistry LLC | Dentist | 717 N Highway 7, Blue Springs, MO 64014-6426 | 2017-03-27 |
| 1932552528 | Gerard Feldhaus Dds PC | Dentist | 415 E 69th Ter, Kansas City, MO 64131-1330 | 2016-07-19 |
| 1356721518 | Christopher Drake | Dentist | 1205 Ne Coronado Dr, Blue Springs, MO 64014-2928 | 2015-06-03 |
| 1811382179 | Robert Paul Hintze | Dentist | 3555 Sunset Office Dr Ste 210, Saint Louis, MO 63127 | 2015-04-03 |
| Find all providers with the same taxonomy | ||||
| City | LEES SUMMIT |
| Zip Code | 64063 |
Please comment or provide details below to improve the information on SUMMIT PEDIATRIC DENTISTRY.
| 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.