CHERRY LANE KIDS DENTISTRY (NPI# 1902325749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902325749 |
| Entity Type | Organization |
| Organization Name | CHERRY LANE KIDS DENTISTRY |
| Practice Address |
1558 N Crestmont Dr Ste A Meridian ID 83642-2194 |
| Mailing Address |
121 Mountain View Dr Nampa ID 83686-8867 |
| Practice Telephone | 2085807091 |
| Practice Fax Number | 2085872624 |
| Mailing Telephone | 2087600335 |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2017-09-13 |
| Authorized Official Name | MS. RHONDA MARIE ELQUIST (REGIONAL OPERATIONS MANAGER) |
| Authorized Official Telephone | 2085807091 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
D-4186-PD | ID | Dental Providers |
| Street Address |
1558 N CRESTMONT DR STE A |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642-2194 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710464219 | Omid Gilani | Dentist | 1558 N Crestmont Dr Ste A, Meridian, ID 83642 | 2018-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174145684 | Ikdo South Meridian LLC | Dentist | 3839 E Amity Rd, Meridian, ID 83642 | 2020-05-07 |
| 1073133328 | Prescription Pad LLC | Pharmacy | 885 S Vanguard Way, Meridian, ID 83642 | 2020-04-16 |
| 1609412683 | Meridian Advanced Psychiatry, LLC | Psychiatry & Neurology | 1672 S Woodsage Ave., Meridan, ID 83642 | 2019-11-25 |
| 1194378927 | Sergey Tsema | Occupational Therapist | 1259 E Pisa St, Meridian, ID 83642 | 2019-07-21 |
| 1003478629 | Chris R Jackson | Dentist | Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 | 2019-07-03 |
| 1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
| 1033772793 | Nugen Healthcare, Pllc | Registered Nurse | 2177 S Spoonbill Ave, Meridian, ID 83642 | 2019-04-18 |
| 1811471790 | Courtney Crossland | Physician Assistant | 4949 S Hillsdale Ave., Meridian, ID 83642 | 2018-09-18 |
| 1841771938 | Katelyn Perry | Counselor | 2068 S. Eagle Rd., Meridian, ID 83642 | 2018-08-27 |
| 1114406204 | Gem Prep: Meridian LLC | Case Management | 2750 E.gala Ct., Meridian, ID 83642 | 2018-08-09 |
| Find all providers in zip 83642 | ||||
| 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 |
|---|---|---|---|---|
| 1720447097 | Brock Coletti | Dentist | 3235 N Towerbridge Way Ste 200, Meridian, ID 83646-5721 | 2016-02-15 |
| 1811156722 | Meridian Pediatric Dentistry, Pllc | Dentist | 1550 E Heritage Park St Ste 150, Meridian, ID 83646-5886 | 2008-06-05 |
| 1659546174 | Randall Parley Blair | Dentist | 37 W Archerfield St Ste 100, Meridian, ID 83646-6587 | 2008-04-25 |
| 1710068739 | J Britt Mccarty | Dentist | 1922 23rd Ave, Meridian, MS 39301-3107 | 2006-10-17 |
| 1407801939 | Toby O Merriman | Dentist | 1550 E Heritage Park St, Ste 150, Meridian, ID 83646-5886 | 2006-05-23 |
| 1326098682 | Joel E Whitt | Dentist | 3235 N Towerbridge Way, Suite 200, Meridian, ID 83646 | 2006-05-10 |
| 1962466292 | Lawrence Wayne Meadors | Dentist | 2300 W Everest Ln, Suite 125, Meridian, ID 83646-5925 | 2006-04-13 |
| 1356606511 | Meridian Pediatric Dental Group, LLC | Dentist | 1922 23rd Ave, Meridian, MS 39301 | 2012-07-12 |
| 1972863678 | Dental Care for Kids | Dentist | 3235 N Towerbridge Way, Suite 200, Meridian, ID 83646-5721 | 2012-05-29 |
| 1760646509 | Shelley Wilkerson Mcdonald | Dentist | 1922 23rd Ave, Meridian, MS 39301-3107 | 2008-07-10 |
| Find all providers in MERIDIAN | ||||
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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.