THOMAS M. PEDAVOLI DDS INC. (NPI# 1215477088) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215477088 |
| Entity Type | Organization |
| Organization Name | THOMAS M. PEDAVOLI DDS INC. |
| Practice Address |
850 Columbus Dr Plymouth IN 46563-1877 |
| Mailing Address |
Po Box 1049 Plymouth IN 46563-5049 |
| Practice Telephone | 5749362527 |
| Practice Fax Number | 5749365363 |
| Mailing Telephone | 5749362527 |
| Mailing Fax Number | 5749365363 |
| Enumeration Date | 2017-02-27 |
| Last Update Date | 2017-02-27 |
| Authorized Official Name | DR. THOMAS MICHAEL PEDAVOLI (OWNER/DENTIST) |
| Authorized Official Telephone | 5749362527 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 12008862A | IN | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | LPI 100323350 B | 05 |
| Street Address |
850 COLUMBUS DR |
| City | PLYMOUTH |
| State | IN |
| Zip Code | 46563-1877 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811547748 | Steven N Wolff | Pharmacist | Walmart #1978, 2505 North Oak Drive, Plymouth, IN 46563 | 2019-09-12 |
| 1295280923 | Multi-county Ems LLC | Ambulance | 5034 Redwood Road, Plymouth, IN 46563 | 2016-08-23 |
| 1356473060 | Donna Michelle Eggers | Speech-Language Pathologist | 1915 Lake Avenue, Plymouth, IN 46563 | 2007-03-09 |
| 1629103684 | Marshall County Council On Aging | Home Delivered Meals | 1305 W Harrison Street, Plymouth, IN 46563 | 2007-02-22 |
| 1063561272 | Associates In Clinical Psychology PC | Psychiatric Residential Treatment Facility | 317 West Monroe St, Plymouth, IN 46563 | 2007-01-09 |
| 1316005911 | Michiana Eye Center LLC | Optometrist | 320 Meadow Ln, Plymouth, IN 46563 | 2006-12-05 |
| 1487722948 | Allen Edward Reese | Hearing Instrument Specialist | 322 N. Michigan St., Suite C, Plymouth, IN 46563 | 2006-12-01 |
| 1508932252 | Thomas A Miller | Chiropractor | 1071 Lincolnway E, Plymouth, IN 46563 | 2006-11-27 |
| 1679540991 | Mukesh Garg | Internal Medicine | 2349 Lake Ave Ste 99, Plymouth, IN 46563 | 2006-03-06 |
| 1982686242 | Woodlawn Hospital | Skilled Nursing Facility | 9601 Union Rd, Plymouth, IN 46563 | 2005-11-14 |
| Find all providers in zip 46563 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760091268 | Haggerty Dental | Dentist | 16000 N Haggerty Rd, Plymouth, MI 48170-4884 | 2020-07-30 |
| 1902460439 | Jose Joaquin Giraud | Dentist | 130 Carr Rd, Plymouth, WI 53073-9500 | 2019-04-30 |
| 1356887186 | Katherine Marlow Bell | Dentist | 2805 Campus Dr Ste 245, Plymouth, MN 55441 | 2017-01-18 |
| 1356792097 | Uvoh Erhiegueke Onoriobe | Dentist | 9301 Mayflower Ct, Plymouth, MI 48170-3923 | 2016-06-23 |
| 1003263989 | Mohammed Almumaiz | Dentist | 45600 Joy Rd, Plymouth, MI 48170-3660 | 2016-05-19 |
| 1528415742 | Revanth Chada | Dentist | 4665 Urbandale Ct N, Plymouth, MN 55446-1946 | 2016-05-17 |
| 1336595941 | Michelle Peters | Dentist | 9416 S Main St Ste 211, Plymouth, MI 48170-4183 | 2016-05-12 |
| 1154798262 | Mark Jurek | Dentist | 556 N Oak Dr, Plymouth, IN 46563-1664 | 2015-08-24 |
| 1336516517 | Dental Center of Plymouth LLC | Dentist | 1913 N Michigan St Ste E, Plymouth, IN 46563-1015 | 2015-08-24 |
| 1619369279 | Hooman Abdolisereshki | Dentist | 62 S Pleasant View Rd # A, Plymouth, WI 53073-4954 | 2015-02-19 |
| Find all providers in PLYMOUTH | ||||
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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.