CRE8TIVE PEDIATRIC DENTAL GROUP (NPI# 1447883863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1447883863 |
Entity Type | Organization |
Organization Name | CRE8TIVE PEDIATRIC DENTAL GROUP |
Practice Address |
2201 Fort Worth Avenue Dallas TX 75211 |
Mailing Address |
2787 N Houston St Apt 4002 Dallas TX 75219-5042 |
Practice Telephone | 9725447524 |
Mailing Telephone | 2819358668 |
Enumeration Date | 2020-02-13 |
Last Update Date | 2020-02-13 |
Authorized Official Name | DR. JESSICA MARSHALL (PEDIATRIC DENTIST/OWNER) |
Authorized Official Telephone | 9725447524 |
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 |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TX | 1841425394 | 05 |
Street Address |
2201 FORT WORTH AVENUE |
City | DALLAS |
State | TX |
Zip Code | 75211 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104317601 | May Amria | Dentist | 3434 W Illinois Ave Ste 307, Dallas, TX 75211 | 2018-05-21 |
1235547787 | Los Barrios Unidos Community Clinic, Inc | Clinic/Center | 4732 W. Illinois, Dallas, TX 75211 | 2014-07-29 |
1568733616 | Amit Sethi | Dentist | 4475 Adler Dr Ste 103, Dallas, TX 75211 | 2012-01-21 |
1265764914 | Thomas Lee Schiller | Dentist | 1441 N. Cockrell Hill Rd.., Dallas, TX 75211 | 2010-02-05 |
1407030570 | Sylvia Dupuy | Speech-Language Pathologist | 1353 N. Westmoreland Rd., Bldg F, Dallas, TX 75211 | 2007-12-24 |
1801088802 | Smile Care Orthodontics | Dentist | 4390 I-30, Ste 200, Dallas, TX 75211 | 2007-08-14 |
1104047364 | Ronald Leon Thomas | Pharmacist | 1350 N. Westmoreland, Pharmacy Service, Dallas, TX 75211 | 2007-05-02 |
1578785515 | Rabiu E Omolaja | Case Manager/Care Coordinator | 1353 N. Westmoreland Road #2, Dallas, TX 75211 | 2007-05-02 |
1982828687 | Yokitha Kenyetta Hamp | Counselor | 1253 Westmoreland, Dallas, TX 75211 | 2007-04-12 |
1285858399 | Cyril Odiachi | Counselor | 1353 N Westmoreland, Building A, Dallas, TX 75211 | 2007-04-12 |
Find all providers in zip 75211 |
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 |
---|---|---|---|---|
1316564990 | Ikids Pediatric Dentistry Lakewood, Pllc | Dentist | 2011 Abrams Parkway, Dallas, TX 75214 | 2020-06-30 |
1851944706 | Buckner Rsvglc Pllc | Dentist | 2702 S Buckner Blvd # 111, Dallas, TX 75227-6903 | 2019-07-19 |
1881170355 | Awesome Kids Dentistry | Dentist | 3217 W Davis St, Dallas, TX 75211-2923 | 2018-07-17 |
1053812081 | Armin Afshar | Dentist | 201 Se Washington St Ste A, Dallas, OR 97338-2860 | 2018-02-25 |
1477077717 | Children's Dental At Preston Trail, PC | Dentist | 17194 Preson Road, Dallas, TX 75248 | 2017-07-28 |
1558897686 | Chandler Choate Borth | Dentist | 8305 Walnut Hill Ln Ste 225, Dallas, TX 75231-4259 | 2017-05-10 |
1629516919 | William Preston Colven Jr. | Dentist | 8355 Walnut Hill Ln Ste 125, Dallas, TX 75231-4237 | 2017-02-07 |
1447797188 | A Smile for Life Pllc | Dentist | 324 Medallion Ctr, Dallas, TX 75214-1580 | 2017-01-19 |
1740649441 | J Diane Colter, Dds, Pa | Dentist | 12300 Inwood Rd., Ste #220, Dallas, TX 75244 | 2016-02-23 |
1568820009 | Ashley Nicole Green | Dentist | 2221 W. Ledbetter Drive, Suite 100, Dallas, TX 75224 | 2016-01-28 |
Find all providers in DALLAS |
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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.