WATERFORD KIDS DENTAL CLUB, PLLC (NPI# 1689224818) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689224818 |
| Entity Type | Organization |
| Organization Name | WATERFORD KIDS DENTAL CLUB, PLLC |
| Practice Address |
3801 Elizabeth Lake Rd Waterford MI 48328-3017 |
| Mailing Address |
4220 Surrey Cross Bloomfield Hills MI 48301-1669 |
| Practice Telephone | 2489092132 |
| Mailing Telephone | 2489092132 |
| Enumeration Date | 2019-09-19 |
| Last Update Date | 2019-09-19 |
| Authorized Official Name | DR. REBECA URQUIOLA (OWNER) |
| Authorized Official Telephone | 2489092132 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Street Address |
3801 ELIZABETH LAKE RD |
| City | WATERFORD |
| State | MI |
| Zip Code | 48328-3017 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104371970 | Duncan Chiropractic Group of Waterford, Pllc | Chiropractor | 3801 Elizabeth Lake Rd, Waterford, MI 48328-3017 | 2016-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477184125 | Lillian Atty | Pharmacist | 1484 Rivona Dr, Waterford, MI 48328 | 2020-01-31 |
| 1437631850 | Rana Ismail | Pharmacist | 3273 West Huron St, Waterford, MI 48328 | 2018-09-01 |
| 1588181978 | India Dunlap | Social Worker | 279 Summit Dr., Waterford, MI 48328 | 2017-08-25 |
| 1689191280 | Sydney Strandberg | Social Worker | 1145 Parkway, Waterford, MI 48328 | 2017-08-24 |
| 1467982074 | Briana Greenlee | Dietitian, Registered | 3819 Faber Terrace, Waterford, MI 48328 | 2017-06-15 |
| 1922537364 | Lourdes Alzheimer's Special Care | Custodial Care Facility | 2400 Watkins Lake Rd, Waterford, MI 48328 | 2017-06-08 |
| 1013446459 | Lourdes Assisted Living | Assisted Living Facility | 2450 Watkins Lake Rd, Waterford, MI 48328 | 2017-06-08 |
| 1588019053 | Legacy Dermatology Group PC | Dermatology | 1392 S Cass Lake Rd, Waterford, MI 48328 | 2016-05-03 |
| 1932567989 | Devenia Denise Clayter | Counselor | 255 Summit Dr, Waterford, MI 48328 | 2016-02-05 |
| 1922409739 | Stacey Diggs | Counselor | 250 Elizabeth Lake Road, Biomed Behavorial Healthcare, Waterford, MI 48328 | 2014-09-11 |
| Find all providers in zip 48328 | ||||
| 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 |
|---|---|---|---|---|
| 1891206421 | Travis Lynell Thomas | Dentist | 909 Hartford Tpke Ste D5, Waterford, CT 06385-4267 | 2017-10-23 |
| 1578083200 | Alexander Joseph Alkass | Dentist | 1132 Voorheis Rd, Waterford, MI 48328-3944 | 2017-06-23 |
| 1578916557 | Stephen Hendricks | Dentist | 5531 Brunswick Blvd, Waterford, MI 48327-2511 | 2016-07-14 |
| 1487900312 | Jeffrey W. Miller | Dentist | 5695 Dixie Hwy, Waterford, MI 48329-1619 | 2012-07-30 |
| 1710208053 | Shane Terry Davidson | Dentist | 5574 Cooley Lake Road, Waterford, MI 48327 | 2010-06-22 |
| 1144492067 | Wayne Eric Pickett | Dentist | 5574 Cooley Lake Rd, Waterford, MI 48327-3015 | 2008-04-01 |
| 1942496278 | Mark Laszlo, Dds, PC | Dentist | 4624 W Walton Blvd, Suite B, Waterford, MI 48329-3566 | 2007-09-20 |
| 1750501854 | Timothy Jm Kaercher | Dentist | 32 Broad Street, Waterford, NY 12188-2414 | 2007-04-30 |
| 1558586636 | George Lim Poy Jr. | Dentist | 7096 Highland Rd, Waterford, MI 48327-1502 | 2007-04-16 |
| 1427170034 | David A Wright | Dentist | 4152 Sashabaw Rd, Waterford, MI 48329-1953 | 2007-04-04 |
| Find all providers in WATERFORD | ||||
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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.