PEDIATRIC DENTAL SPECILAIST, P.C
NPI 1255063244
Dentist - Pediatric Dentistry in Port Huron, MI

Q: What is Pediatric Dental Specilaist, P.C's NPI number?

The NPI number for Pediatric Dental Specilaist, P.C is 1255063244. It was assigned to this organization in the NPPES registry on June 28, 2022.

Q: What is Pediatric Dental Specilaist, P.C's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

Active since June 28, 2022

1026 SUPERIOR ST, PORT HURON, MI 48060(810) 987-5040(810) 987-9499 Get Directions Write a Review

NPPES record last updated: July 26, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 26, 2022, Jul 21, 2022 (2 updates tracked since 2022).

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About Pediatric Dental Specilaist, P.c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEDIATRIC DENTAL SPECILAIST, P.C (NPI 1255063244) is a healthcare organization registered as a pediatric dentistry in Port Huron, Michigan and active in the NPI registry since June 2022. The organization lists Kacey A Woodward, Receptionist, as its authorized official.

NPPES Registry Identity

NPI1255063244

Entity TypeOrganization

Primary Taxonomy1223P0221X

Legal Business NamePEDIATRIC DENTAL SPECILAIST, P.C

Location Address1026 SUPERIOR STPort Huron, MI 48060-3748

Mailing Address1026 Superior StPort Huron, MI 48060-3748 · (810) 987-5040 · Fax (810) 987-9499

Phone(810) 987-5040

Fax(810) 987-9499

Organization SubpartNo

Authorized OfficialKacey A WoodwardReceptionist · (810) 987-5040

Enumeration DateJune 28, 2022

Last NPPES UpdateJuly 26, 20222 updates tracked since enumeration

NPPES CertifiedJuly 26, 2022

✔ NPI 1255063244 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers

Taxonomy Code1223P0221X

Definition

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.

1026 SUPERIOR ST, Port Huron, MI 48060

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Other Identifiers 1

Medicaid4032586MI

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DOUGLAS STEPHEN BARIBEAU DDS

Dentist (Pediatric Dentistry)

1026 SUPERIOR ST
PORT HURON, MI 48060

St. Clair County (810) 987-5040

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pediatric Dental Specilaist, P.C's NPI number?

The NPI number for Pediatric Dental Specilaist, P.C is 1255063244. It was assigned to this organization in the NPPES registry on June 28, 2022.

Where is Pediatric Dental Specilaist, P.C located?

Pediatric Dental Specilaist, P.C is located at 1026 Superior St, Port Huron, MI 48060. The listed phone number is (810) 987-5040.

What is Pediatric Dental Specilaist, P.C's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Pediatric Dental Specilaist, P.C was last updated on July 26, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.