CENTER FOR PEDIATRIC DENTISTRY, PC (NPI# 1164490918) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164490918 |
| Entity Type | Organization |
| Organization Name | CENTER FOR PEDIATRIC DENTISTRY, PC |
| Practice Address |
1243 Augusta West Pkwy Augusta GA 30909-1807 |
| Practice Telephone | 7068558989 |
| Practice Fax Number | 7068550321 |
| Mailing Telephone | 7068558989 |
| Mailing Fax Number | 7068550321 |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2013-06-19 |
| Authorized Official Name | DR. LEE H BAKER (PRESIDENT/DENTIST) |
| Authorized Official Telephone | 7068558989 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
11680 | GA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 945328611A | 05 |
| Street Address |
1243 AUGUSTA WEST PKWY |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30909-1807 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295935534 | Melissa Shaw | Dentist | 1243 Augusta West Pkwy, Augusta, GA 30909-1807 | 2007-07-24 |
| 1285702332 | Kelly Wallace Hughes | Dentist | 1243 Augusta West Pkwy, Augusta, GA 30909-1807 | 2006-11-30 |
| 1619936267 | Lee House Baker | Dentist | 1243 Augusta West Pkwy, Augusta, GA 30909-1807 | 2006-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912513888 | Lauran Simpson | Behavior Technician | 1237 Augusta West Parkway, Augusta, GA 30909 | 2020-09-16 |
| 1487273884 | Still Perspectives Counseling LLC | Counselor | 1265 Inerstate Prwy, Suite B, Augusta, GA 30909 | 2020-04-15 |
| 1598397838 | Mjra Medical LLC | Psychologist | 3675 J Dewey Gray Cr Ste 300, Augusta, GA 30909 | 2020-02-05 |
| 1003452319 | Danny Robinson | Counselor | 2609 Commons Boulevard, Augusta, GA 30909 | 2019-11-21 |
| 1407498637 | Candice M Cruse | Social Worker | 2609 Commons Blvd, Augusta, GA 30909 | 2019-10-09 |
| 1902363385 | Mary D Jodon | Pharmacist | 3338 Wrightsboro Rd., Augusta, GA 30909 | 2019-02-21 |
| 1447790514 | Burn Critical Care Associates, LLC | Internal Medicine | 3614 J. Dewey Gray Circle, Bldg B., Augusta, GA 30909 | 2017-03-08 |
| 1124561766 | Sasha Latara Mccraw | Counselor | 7303 Palomino Court, Augusta, GA 30909 | 2016-11-30 |
| 1174974620 | Warren Umansky, Ph.d. | Psychologist | 302 Wheeler Executive Ctr, Augusta, GA 30909 | 2016-06-27 |
| 1811358955 | Theodora Mcleskey | Nurse Practitioner | 1215 George C. Wilson Drive, Augusta, GA 30909 | 2016-03-17 |
| Find all providers in zip 30909 | ||||
| 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 |
|---|---|---|---|---|
| 1497198154 | Brittany Rose Waters | Dentist | 2070 Reserve Ln, Augusta, GA 30907-6215 | 2013-04-12 |
| 1366708653 | June Murakaru | Dentist | 1120 15th St # Gc-2133, Augusta, GA 30912-0004 | 2012-04-11 |
| 1922188085 | Phillip Hickson Miller | Dentist | 104 Kings Chapel Rd, Augusta, GA 30907-4001 | 2006-10-16 |
| 1699873786 | I Gary Katcoff | Dentist | 3559 Wheeler Road, Augusta, GA 30909 | 2006-09-20 |
| 1306868872 | Michael Milano | Dentist | 1430 John Wesley Gilbert Drive Au Dental Associates, Augusta, GA 30912-7450 | 2006-07-24 |
| 1982644142 | Andrew Durbin Chandler | Dentist | 525 Pleasant Home Rd, Augusta, GA 30907-3525 | 2006-06-07 |
| 1245879006 | Pediatric Dental Associates of Atlanta | Dentist | 525 Pleasant Home Rd, Augusta, GA 30907-3525 | 2019-12-26 |
| 1801433750 | Mainely Kids & Teens, LLC | Dentist | 8 Shuman Ave, Augusta, ME 04330-7751 | 2019-12-10 |
| 1669815296 | Andrew Shoemaker | Dentist | 1430 John Wesley Gilbert Dr, Augusta, GA 30912-0001 | 2013-04-13 |
| 1972851954 | Michael Lee Minyard | Dentist | 1120 15th St, Augusta, GA 30912-2960 | 2012-08-22 |
| Find all providers in AUGUSTA | ||||
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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.