PEDIATRIC DENTAL GROUP OF LAFAYETTE (NPI# 1326211863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326211863 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC DENTAL GROUP OF LAFAYETTE |
| Other Organization Name | DR. DAVID STRANGE |
| Practice Address |
300 Exempla Cir Ste 460 Lafayette CO 80026 |
| Mailing Address |
300 Exempla Cir Ste 460 Lafayette CO 80026-3396 |
| Practice Telephone | 7208909494 |
| Practice Fax Number | 7208901444 |
| Mailing Telephone | 7208909494 |
| Mailing Fax Number | 7208901444 |
| Enumeration Date | 2008-04-04 |
| Last Update Date | 2018-05-21 |
| Authorized Official Name | MRS. NICOLE HARTSHORN (PRACTICE MANAGER) |
| Authorized Official Telephone | 7208909494 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
CO | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 39021378 | 05 |
| Other Name | Type Code |
|---|---|
| Dr. David Strange | Other Name - Individual/Organization |
| Street Address |
300 EXEMPLA CIR STE 460 |
| City | LAFAYETTE |
| State | CO |
| Zip Code | 80026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528671690 | Julia Michele Colton | Occupational Therapist | 110 S. Roosevelt Ave, Lafayette, CO 80026 | 2020-08-28 |
| 1265045900 | Amber M. Roter | Social Worker | 588 N Us-287 Co, Suite 200, Lafayette, CO 80026 | 2020-08-24 |
| 1669008314 | Dr. Sunda Friedman Tebockhorst Psychologicl Services, Ltd | Clinic/Center | 588 N Hwy 287, Suite 200, Lafayette, CO 80026 | 2020-03-13 |
| 1659918910 | Emily Nicole Pearson | Behavior Technician | 961 Sandstone Circle, Lafayette, CO 80026 | 2019-12-05 |
| 1790320612 | Gs Campus Asc, LLC | Clinic/Center | Lafayette Surgery Center, 340 Exempla Circle, Suite #400, Lafayette, CO 80026 | 2019-11-14 |
| 1639711864 | Martina Christina Holzach | Student in an Organized Health Care Education/Training Program | 1455 Dixon Ave, Suite #300, Lafayette, CO 80026 | 2019-10-09 |
| 1104474055 | 2nd Star Counseling | Clinic/Center | 260 S. Public Rd, Lafayette, CO 80026 | 2019-09-03 |
| 1912460015 | Premier Eye Surgery Center of Colorado, LLC | Clinic/Center | 1050 W. South Boulder Road, Lafayette, CO 80026 | 2019-04-08 |
| 1144704883 | Nikole J Randolph | Nutritionist | 2770 Dagny Way Suite 210, Lafayette, CO 80026 | 2018-09-19 |
| 1609388842 | Claro Scientific Laboratories Corp | Clinical Medical Laboratory | 1408 Horizon Ave Ste 101, Lafayette, CO 80026 | 2017-10-27 |
| Find all providers in zip 80026 | ||||
| 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 |
|---|---|---|---|---|
| 1629407770 | Shilpa Nileshwar | Dentist | 210 Beaullieu Dr, Lafayette, LA 70508-7226 | 2013-11-08 |
| 1932426970 | Barnali Roy | Dentist | 3501 School St, Lafayette, CA 94549-4505 | 2010-04-30 |
| 1396974655 | S. Troy Miller Dds Apdc | Dentist | 500 Dover Blvd Ste 300, Lafayette, LA 70503-5000 | 2009-07-08 |
| 1720115058 | Leslie J Jacobs | Dentist | 113 Rue Fontaine, Lafayette, LA 70508 | 2007-02-27 |
| 1912085903 | Roland R Ditto Sr. | Dentist | 2347 Cason St, Lafayette, IN 47904-2670 | 2006-11-01 |
| 1689758096 | Carl B Gonsoulin | Dentist | 126 Hospital Dr, Lafayette, LA 70503-2819 | 2006-10-24 |
| 1902855398 | William A Keaty | Dentist | 350 Doucet Rd, Lafayette, LA 70503-3415 | 2006-05-10 |
| 1417577461 | Hannah Boudreaux Noto | Dentist | 185 S Beadle Rd, Lafayette, LA 70508-4287 | 2020-04-20 |
| 1871034397 | R K Nassiri, Dds, Msd, Inc | Dentist | 3466 Mt Diablo Blvd, Suite C207, Lafayette, CA 94549-7106 | 2017-03-16 |
| 1386182418 | Anita J Gouri Dds LLC | Dentist | 350 Doucet Rd, Ste 101, Lafayette, LA 70503-3415 | 2017-02-09 |
| Find all providers in LAFAYETTE | ||||
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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.