DR. GARY LEE KISTNER (NPI# 1851507271) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851507271 |
| Entity Type | Individual |
| Full Name | DR. GARY LEE KISTNER |
| Credential | DDS |
| Practice Address |
2 Hospital Dr Tyrone PA 16686-1805 |
| Mailing Address |
405 E Springwood Pl Port Matilda PA 16870-7021 |
| Practice Telephone | 8146842499 |
| Mailing Telephone | 8142349014 |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
DS022565L | PA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | UNITED CONCORDIA | 438677 | 01 |
| PA | 0000789980003 | 05 |
| Street Address |
2 HOSPITAL DR |
| City | TYRONE |
| State | PA |
| Zip Code | 16686-1805 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548660129 | Rite Aid of Pennsylvania LLC | Durable Medical Equipment & Medical Supplies | 1365 Logan Avenue, Tyrone, PA 16686 | 2014-09-02 |
| 1750696571 | Amanda J. Kunsman | Physician Assistant | 1400 Pennsylvania Avenue, Tyrone, PA 16686 | 2010-08-17 |
| 1386884310 | Gary A Raymond Dpm PC | Podiatrist | 154 Hospital Drive, Suite 4, Tyrone, PA 16686 | 2009-03-04 |
| 1376664755 | Med Center Pharmacy | Pharmacy | Cloy Ave Extension, Tyrone, PA 16686 | 2007-04-03 |
| 1427194778 | Robert James Sloss | Dentist | 1006 Logan Ave, Tyrone, PA 16686 | 2007-01-30 |
| 1538222872 | Larry Michael Koren | Chiropractor | Rd 4 Box 3a, Tyrone, PA 16686 | 2006-12-18 |
| 1417057134 | Francis J Mcclain | Dentist | 1014 Logan Avenue, Tyrone, PA 16686 | 2006-09-23 |
| 1174598304 | William James Mazzocco Jr. | Physician Assistant | Tyrone Hospital, One Hospital Drive, Tyrone, PA 16686 | 2006-02-21 |
| 1447224332 | David R Arbutina | Surgery | 154 Hospital Drive, Suite 5, Tyrone, PA 16686 | 2006-02-15 |
| 1336421965 | Nittany Eye Associates | Optometrist | 175 Hospital Drive, Tyrone, PA 16686 | 2011-09-09 |
| Find all providers in zip 16686 | ||||
| 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 |
|---|---|---|---|---|
| 1801246079 | Little Peaches Pediatric Dentistry | Dentist | 120 Handley Rd, Suite 210, Tyrone, GA 30290-2177 | 2016-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598309106 | Sea of Smiles 4 LLC | Dentist | 361 Highland Ave Ste 203, Jenkintown, PA 19046-2632 | 2019-11-06 |
| 1538701594 | John Capparell & Connie Mallozzi | Dentist | 20 N Laurel St # 2-c, Hazleton, PA 18201-5948 | 2019-10-11 |
| 1215584503 | Bright Smiles Kids Dentistry | Dentist | 410 W Lancaster Ave Ste 106, Devon, PA 19333-1588 | 2019-08-21 |
| 1841846458 | Bensalem, Smiles Inc | Dentist | 2548 Street Rd, Bensalem, PA 19020-2644 | 2019-08-11 |
| 1154976991 | Advanced Pediatric Dentistry LLC | Dentist | 220 Cumberland Pkwy Ste 6&7, Mechanicsburg, PA 17055-5683 | 2019-08-08 |
| 1205495512 | Lanz Pediatric Dentistry, LLC | Dentist | 3402 Washington Rd Ste 205, Mc Murray, PA 15317-2964 | 2019-06-10 |
| 1982267084 | Farm Park Pediatric Dentistry | Dentist | 502 W Germantown Pike Ste 100, East Norriton, PA 19403-4232 | 2019-04-15 |
| 1053878892 | Alexis Gilliam | Dentist | 2820 Whiteford Rd, York, PA 17402-7620 | 2019-02-28 |
| 1346705050 | Happy Teeth Proffesionals, LLC | Dentist | 165 Levittown Pkwy Ste B, Levittown, PA 19055-2464 | 2019-02-06 |
| 1902373111 | Cavity Busters Doylestown LLC | Dentist | 708 N Shady Retreat Rd Ste 2, Doylestown, PA 18901-2503 | 2018-10-25 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. GARY LEE KISTNER.
| 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.