SERENITY SMILES FAMILY DENTISTRY, LLC (NPI# 1891133583) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891133583 |
| Entity Type | Organization |
| Organization Name | SERENITY SMILES FAMILY DENTISTRY, LLC |
| Practice Address |
2401 Bernadette Dr Ste 217 Columbia MO 65203-4672 |
| Mailing Address |
1700 Skylane Dr Columbia MO 65202-1709 |
| Practice Telephone | 5734451100 |
| Mailing Telephone | 5734451100 |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2013-06-05 |
| Authorized Official Name | DANA DERDEUFF (OWNER/DENTIST) |
| Authorized Official Telephone | 5733564029 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
2012015356 | MO | Dental Providers |
| Street Address |
2401 BERNADETTE DR STE 217 |
| City | COLUMBIA |
| State | MO |
| Zip Code | 65203-4672 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053328815 | Charles Curtis Hatley Jr. | Dentist | 2401 Bernadette Dr, Ste 217, Columbia, MO 65203-4672 | 2006-08-02 |
| 1710236427 | Janet Nelson Walden | Physical Therapist | 2401 Bernadette Dr, Ste 202, Columbia, MO 65203-4672 | 2012-09-10 |
| 1720338478 | Columbia Balance & Dizziness Center LLC | Clinic/Center | 2401 Bernadette Dr, Ste 202, Columbia, MO 65203-4672 | 2012-09-10 |
| 1053699165 | Dana Lee Beaini | Dentist | 2401 Bernadette Dr, Suite 217, Columbia, MO 65203-4672 | 2011-07-25 |
| 1982918884 | Matchstick LLC | Dentist | 2401 Bernadette Dr, Suite 217, Columbia, MO 65203-4672 | 2010-08-03 |
| 1477780518 | Bernadette Dental | Dentist | 2401 Bernadette Dr, Ste 217, Columbia, MO 65203-4672 | 2009-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982229498 | Rebecca Wallace Counseling LLC | Clinic/Center | 207 Peach Way, Suite 110, Columbia, MO 65203 | 2020-06-10 |
| 1144797101 | Mary Zhang | Family Medicine | 200 Southampton Drive, Ste 102, Columbia, MO 65203 | 2018-10-29 |
| 1871090258 | Hina Omer Khokhar | Pathology | 4601 Apt F West Millbrook Dr, Columbia, MO 65203 | 2018-04-11 |
| 1154820157 | David Vincent Spencer | Internal Medicine | 201 W Broadway Building, Suite E, Columbia, MO 65203 | 2018-02-05 |
| 1598283103 | Donna Strickland | Counselor | 201 W Broadway Bldg 2, Suite F, Columbia, MO 65203 | 2017-09-03 |
| 1134643182 | Anna Kathryn Christensen | Physician Assistant | 4107 Baurichter Dr., Columbia, MO 65203 | 2017-08-01 |
| 1558885871 | Juan Camilo Pineda | Internal Medicine | 210 Portland Street Suite 104, Columbia, MO 65203 | 2017-07-28 |
| 1922530096 | The Missing L Inc | Community/Behavioral Health | 3605 S. Providence Rd, Suite 6, Columbia, MO 65203 | 2017-03-29 |
| 1689118010 | Linda Landry | Nurse Practitioner | 1000 W. Nifong, Bldg 2 Suite 150, Columbia, MO 65203 | 2016-12-04 |
| 1417313552 | Brittany Lea Ramirez | Chiropractor | 2001 Corona Rd Ste 205, Columbia, MO 65203 | 2016-01-05 |
| Find all providers in zip 65203 | ||||
| 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 |
|---|---|---|---|---|
| 1184239832 | Adam Wesley Gadbois | Dentist | 220 Diego Dr, Columbia, MO 65203-4919 | 2020-09-10 |
| 1841803855 | Craig Thomas Luskey | Dentist | 4500 Stuart St Fl 3, Columbia, SC 29207-5700 | 2020-08-28 |
| 1710505169 | Dentists of Devine, PC | Dentist | 4600 Devine St Ste B, Columbia, SC 29205-3617 | 2020-07-13 |
| 1134745227 | Kayla White | Dentist | 1401 Forum Blvd Ste 203, Columbia, MO 65203-1915 | 2020-06-24 |
| 1962033001 | Ivy Creek Family Dentistry LLC | Dentist | 9007 Two Notch Rd Ste B, Columbia, SC 29223-5834 | 2020-01-28 |
| 1538701230 | Sulekha Agrawal Dmd LLC | Dentist | 9194 Red Branch Rd Ste A, Columbia, MD 21045-2005 | 2019-10-14 |
| 1619522794 | Timothy Drew Edwards | Dentist | 122 N. Brickyard Rd, Columbia, SC 29223 | 2019-08-06 |
| 1245885284 | Mana Shoeybi | Dentist | 6955 Oakland Mills Rd Ste 0, Columbia, MD 21045-5849 | 2019-08-06 |
| 1528628716 | Soh of Missouri Samson Liu PC | Dentist | 303 N Keene St # 202-210, Columbia, MO 65201-8050 | 2019-06-19 |
| 1417511783 | Molly Kayleen Pincelli | Dentist | Ph Usc Medical Group Dentistry, 10 Medical Park, Columbia, SC 29203 | 2019-04-23 |
| Find all providers in COLUMBIA | ||||
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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.