1. Home
  2. Directory
  3. Montana
  4. Missoula
  5. Dentist
  6. NPI Profile

MISSOULA PEDIATRIC DENTISTRY, PLLC
NPI 1578993531
Dentist - Pediatric Dentistry in Missoula, MT

Active since November 12, 2013
3020 S RESERVE ST, SUITE D, MISSOULA, MT 59801(406) 541-7334(406) 541-7338 Get Directions Write a Review

NPPES record last updated: November 12, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Missoula Pediatric Dentistry, Pllc NPPES

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

MISSOULA PEDIATRIC DENTISTRY, PLLC (NPI 1578993531) is a healthcare organization registered as a pediatric dentistry in Missoula, Montana and active in the NPI registry since November 2013. The organization lists Paul Leonard Tiede, Business Manager, as its authorized official.

NPPES Registry Identity

NPI1578993531
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameMISSOULA PEDIATRIC DENTISTRY, PLLC
Location Address3020 S RESERVE ST, SUITE DMissoula, MT 59801-7652
Mailing Address3020 S Reserve St, Suite DMissoula, MT 59801-7652 · (406) 541-7334 · Fax (406) 541-7338
Phone(406) 541-7334
Fax(406) 541-7338
Organization SubpartNo
Authorized OfficialPaul Leonard TiedeBusiness Manager · (406) 541-7334
Enumeration DateNovember 12, 2013
✔ NPI 1578993531 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in MT · MT2151
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.
3020 S RESERVE ST, Missoula, MT 59801
Open in Google Maps ↗

Other Identifiers 1

Medicaid1942483524MT

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 2

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

MISSOULA ORAL SURGERY
Clinic/Center (Oral and Maxillofacial Surgery)
3020 S RESERVE ST, SUITE C
MISSOULA, MT 59801
Missoula County (406) 552-9970
MISA04, LLC
Dentist (General Practice)
3020 S RESERVE ST
MISSOULA, MT 59801
Missoula County (406) 697-5756

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 Missoula Pediatric Dentistry, PLLC's NPI number?

The NPI number for Missoula Pediatric Dentistry, PLLC is 1578993531. It was assigned to this organization in the NPPES registry on November 12, 2013.

Where is Missoula Pediatric Dentistry, PLLC located?

Missoula Pediatric Dentistry, PLLC is located at 3020 S Reserve St Suite D, Missoula, MT 59801. The listed phone number is (406) 541-7334.

What is Missoula Pediatric Dentistry, PLLC'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 Missoula Pediatric Dentistry, PLLC was last updated on November 12, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.