A DENTAL HOME 4 KIDZ (NPI# 1366060618) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366060618 |
| Entity Type | Organization |
| Organization Name | A DENTAL HOME 4 KIDZ |
| Practice Address |
155 Carnegie Pl Ste 201 Fayetteville GA 30214-3981 |
| Practice Telephone | 7708715158 |
| Mailing Telephone | 7708715158 |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2020-07-13 |
| Authorized Official Name | LONA BIBBS (PARTNER) |
| Authorized Official Telephone | 7708715158 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Street Address |
155 CARNEGIE PL STE 201 |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30214-3981 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
| 1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
| 1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
| 1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
| 1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
| 1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
| Find all providers in zip 30214 | ||||
| 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 |
|---|---|---|---|---|
| 1508334400 | Smile Shoppe Fayetteville Jeffrey D. Rhodes Dds Ms Pllc | Dentist | 3484 W Wedington Dr, Fayetteville, AR 72704-5730 | 2018-11-08 |
| 1134405848 | Eaglin Dental Group, Fayetteville | Dentist | 692 Glynn St N Ste S, Fayetteville, GA 30214-6705 | 2011-10-26 |
| 1689974362 | Karen Anne Green | Dentist | 1607 E Rainforest Rd, Fayetteville, AR 72703 | 2010-10-27 |
| 1083872915 | Shannitta Latrease Bridgers | Dentist | 1367 Walter Reed Rd, Suite 103, Fayetteville, NC 28304 | 2008-05-28 |
| 1346300209 | Pediatric Dentistry & Interceptive Orthodontics P.C. | Dentist | 8016 E Genesee St, Fayetteville, NY 13066-9692 | 2006-12-11 |
| 1710052279 | Warren Coleman Massey | Dentist | 3089 E Mission Blvd, Fayetteville, AR 72703-4385 | 2006-11-21 |
| 1154401057 | Triplett, Sanders, Tompkins, Smith Pediatric Dentistry | Dentist | 1607 E Rainforest Dr, Fayetteville, AR 72703-5385 | 2006-10-16 |
| 1255422424 | Fred B Dunkelberger | Dentist | 570 W Lanier Avenue, Bldg #2, Fayetteville, GA 30214 | 2006-09-27 |
| 1073537627 | Yvette Mcalister Stokes, Dds, Pa | Dentist | 1770 Metromedical Dr, Fayetteville, NC 28304-3861 | 2006-07-27 |
| 1083657597 | Yvette Mcalister Stokes | Dentist | 1367 Walter Reed Rd Ste 103, Fayetteville, NC 28304 | 2006-06-13 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30214 |
Please comment or provide details below to improve the information on A DENTAL HOME 4 KIDZ.
| 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.