LARRY G PAYNE DDS LC (NPI# 1255884425) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255884425 |
| Entity Type | Organization |
| Organization Name | LARRY G PAYNE DDS LC |
| Other Organization Name | WATERLOO FAMILY DENTISTRY |
| Practice Address |
605 S Wayne St Waterloo IN 46793-9472 |
| Practice Telephone | 2608372138 |
| Practice Fax Number | 2608377481 |
| Mailing Telephone | 2608372138 |
| Mailing Fax Number | 2608377481 |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2016-07-25 |
| Authorized Official Name | DIANNA J PAYNE (VICE PRESIDENT/ OFFICE MANAGER) |
| Authorized Official Telephone | 2608372138 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | Dental Providers | ||
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Waterloo Family Dentistry | Doing Business As Name - Organization |
| Street Address |
605 S WAYNE ST |
| City | WATERLOO |
| State | IN |
| Zip Code | 46793-9472 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487703286 | Larry G Payne | Dentist | 605 S Wayne St, Waterloo, IN 46793-9472 | 2007-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124030101 | Lee Joseph Nagel | Chiropractor | 3386 Co. Rd. 427, Waterloo, IN 46793 | 2006-08-11 |
| 1639283880 | Dr Lee Nagel PC | Chiropractor | 3386 Co. Rd. 427, Waterloo, IN 46793 | 2006-08-17 |
| 1013486976 | Michelle Diane Dunn | Doula | 2181 County Road 27, Waterloo, IN 46793-9413 | 2018-11-20 |
| 1912133968 | Carly L Everingham | Developmental Therapist | 820 Innkeepers Ct, Waterloo, IN 46793-9499 | 2009-06-04 |
| 1063745693 | Charlene R Kincaid | Social Worker | 535 N Wayne St, Waterloo, IN 46793-9701 | 2009-09-15 |
| 1487026753 | Zachary Thiele | Specialist/Technologist | 1892 County Road 51, Waterloo, IN 46793-9750 | 2015-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891395448 | Amanda Hurtt | Pharmacist | 961 N Market St Stop 1, Waterloo, IL 62298-1061 | 2020-10-31 |
| 1679173967 | Tina Marie Moore | Adult Companion | 347 Covington Dr Ste A, Waterloo, IL 62298-3287 | 2020-10-27 |
| 1588261705 | Mobile Therapy Centers of Iowa LLC | Behavioral Analyst | 3520 Inverness Rd, Waterloo, IA 50701-4634 | 2020-10-01 |
| 1942817218 | Fresenius Medical Care Ottumwa, LLC | Clinic/Center | 1655 E San Marnan Dr Ste E, Waterloo, IA 50702-4380 | 2020-09-30 |
| 1629684709 | Peoples Community Health Clinic, Inc | Clinic/Center | 425 1/2 East Ridgeway Ave., Waterloo, IA 50702 | 2020-09-23 |
| 1659986438 | Melissa Anne Stenberg | Registered Nurse | 65 Center St, Waterloo, NY 13165-1024 | 2020-09-09 |
| 1508471418 | Waterloo Urgent Care Walk In Clinic Company | Clinic/Center | 901 Illinois Route 3, Waterloo, IL 62298 | 2020-09-09 |
| 1568076594 | Michelle Ann Tsatsos | Speech-Language Pathologist | 24918 Mason St, Waterloo, NE 68069-4434 | 2020-09-08 |
| 1174137061 | Kristina Gates | Registered Nurse | 604 Lafayette St Ste 202, Waterloo, IA 50703-4708 | 2020-09-08 |
| 1528672904 | Emily Banzer Jensen | Speech-Language Pathologist | 71 Inslee St, Waterloo, NY 13165-1531 | 2020-09-03 |
| Find all providers in WATERLOO | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659753069 | Hannah Rose Leuschen | Dentist | 4015 Hurst Dr, Waterloo, IA 50701-9035 | 2015-06-22 |
| 1437571320 | Waterloo Family Dental | Dentist | 245 N. Monroe Street, Waterloo, WI 53594 | 2014-01-10 |
| 1164773735 | Stephen Frederick Hartman | Dentist | 107 North Virginia Street, Waterloo, NY 13165 | 2012-09-24 |
| 1447400791 | Dr John F Blattner & Dr Dwight D Heberer PC | Dentist | 226 Westview Plaza Dr, Waterloo, IL 62298-1253 | 2008-09-23 |
| 1720236128 | Bradley W Mitchell | Dentist | 413 W 3rd St, Waterloo, IL 62298-1358 | 2008-08-28 |
| 1386808079 | Christopher Glenn Eastman | Dentist | 2765 Crossroads Blvd, Waterloo, IA 50702 | 2008-07-11 |
| 1033237318 | Dr Darryll L Beard Dmd Ltd | Dentist | 208 Bradford Lane, Waterloo, IL 62298 | 2007-03-26 |
| 1043363757 | Martin E. Averill | Dentist | 2102 Kimball Ave, Waterloo, IA 50702-5037 | 2007-01-18 |
| 1487703286 | Larry G Payne | Dentist | 605 S Wayne St, Waterloo, IN 46793-9472 | 2007-01-09 |
| 1689730327 | John Vernon Jetty | Dentist | 86 Center St, Waterloo, NY 13165-1026 | 2006-12-28 |
| Find all providers in WATERLOO | ||||
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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.