BLUEGRASS PEDIATRIC DENTISTRY (NPI# 1619284148) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619284148 |
| Entity Type | Organization |
| Organization Name | BLUEGRASS PEDIATRIC DENTISTRY |
| Practice Address |
120 Meridian Way Suite 2 Richmond KY 40475 |
| Mailing Address |
120 Meridian Way Suite # 2 Richmond KY 40475 |
| Practice Telephone | 8596261810 |
| Mailing Telephone | 8596261810 |
| Enumeration Date | 2010-09-03 |
| Last Update Date | 2016-06-16 |
| Authorized Official Name | DR. JEFFREY LUCAS BOWEN (DENTIST) |
| Authorized Official Telephone | 8596261810 |
| Authorized Official Credential | D.M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Street Address |
120 MERIDIAN WAY SUITE 2 |
| City | RICHMOND |
| State | KY |
| Zip Code | 40475 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356559777 | Jeffrey Lucas Bowen | Dentist | 120 Meridian Way, Suite 2, Richmond, KY 40475 | 2007-05-18 |
| 1265698815 | John Zechariah Thobaben | Dentist | 120 Meridian Way, Suite 2, Richmond, KY 40475 | 2008-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922611300 | Christina Panter | Social Worker | 370 Highland Drive, Ste 1a, Richmond, KY 40475 | 2020-08-26 |
| 1952875387 | Visionary Therapy Center, LLC | Speech-Language Pathologist | 100 Ky Hwy 15 South, Suite 136, Jackson, KY 40475 | 2019-01-18 |
| 1639656911 | Brian Kettler | Physical Therapy Assistant | 2025 Corporate Dr Ste 2, Richmond, KY 40475 | 2018-07-19 |
| 1376063198 | Erin Danielle Burt | Developmental Therapist | 100 Eastern Hills Drive, Richmond, KY 40475 | 2017-06-22 |
| 1477088730 | Paul Henley Jr. | Student in an Organized Health Care Education/Training Program | 157 Shelby Court, Richmond, KY 40475 | 2017-04-25 |
| 1700310455 | Center for Behavioral Health Kentucky, Inc. | Clinic/Center | 1018 Ival Jame Bvld, Suite C, Richmond, KY 40475 | 2017-04-19 |
| 1790221000 | Darisha Jenkins | Counselor | 435 Gibson Lane, Richmond, KY 40475 | 2017-01-10 |
| 1992259402 | Kendra Gross | Counselor | 451 Big Hill Ave Ste 5, Richmond, KY 40475 | 2016-08-12 |
| 1386095032 | Shantila Nicole Wolford | Case Manager/Care Coordinator | 411 Gibson Lane, Richmond, KY 40475 | 2016-06-23 |
| 1154776540 | Jessica Conley | Social Worker | 105 Masters Court, Richmond, KY 40475 | 2016-05-04 |
| Find all providers in zip 40475 | ||||
| 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 |
|---|---|---|---|---|
| 1578115275 | H&a Orthodontics | Dentist | 16733 W Airport Blvd, Building A, Suite 2, Richmond, TX 77407 | 2019-07-12 |
| 1528627916 | Petite Smiles Pediatric Dentistry, Pllc | Dentist | 11131 Harlem Rd, Suite 120, Richmond, TX 77406 | 2019-06-10 |
| 1144627555 | David W Merrell Dds Msd Plc | Dentist | 12205 Gayton Road, Suite A, Richmond, VA 23238-3212 | 2014-12-01 |
| 1356559777 | Jeffrey Lucas Bowen | Dentist | 120 Meridian Way, Suite 2, Richmond, KY 40475 | 2007-05-18 |
| 1396890927 | Rhonda H. Cormney | Dentist | 519 Hampton Way Ste 1, Richmond, KY 40475-8885 | 2007-01-24 |
| 1548334071 | William O Dahlke Jr. | Dentist | 521 N 11th St Ste 305, Richmond, VA 23298 | 2006-11-17 |
| 1619054939 | James M Keeton Jr. | Dentist | 7410 Hull Street Rd, Richmond, VA 23235-5834 | 2006-11-01 |
| 1295825123 | Jack J. Reynolds Jr. | Dentist | 1002 Oak Dr, Richmond, IN 47374-1916 | 2006-10-13 |
| 1861597718 | Hayden R. Phillips | Dentist | 1012 Ival James Blvd, C, Richmond, KY 40475-8174 | 2006-09-14 |
| 1093819013 | Jeffrey Patrick Blair | Dentist | 12205 Gayton Rd, Richmond, VA 23238-3219 | 2006-09-11 |
| Find all providers in RICHMOND | ||||
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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.