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GREEN MOUNTAIN PEDIATRIC DENTISTRY, PLLC
NPI 1912469297
Dentist - Pediatric Dentistry in South Burlington, VT

Active since April 04, 2019
42 TIMBER LN, SOUTH BURLINGTON, VT 05403(802) 332-6808(802) 332-6807 Get Directions Write a Review

NPPES record last updated: April 4, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Green Mountain Pediatric Dentistry, Pllc NPPES

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

GREEN MOUNTAIN PEDIATRIC DENTISTRY, PLLC (NPI 1912469297) is a healthcare organization registered as a pediatric dentistry in South Burlington, Vermont and active in the NPI registry since April 2019. The organization lists Barry L Jacobson, Owner, as its authorized official.

NPPES Registry Identity

NPI1912469297
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameGREEN MOUNTAIN PEDIATRIC DENTISTRY, PLLC
Location Address42 TIMBER LNSouth Burlington, VT 05403-7204
Mailing Address42 Timber LnSouth Burlington, VT 05403-7204 · (802) 332-6808 · Fax (802) 332-6807
Phone(802) 332-6808
Fax(802) 332-6807
Organization SubpartNo
Authorized OfficialBarry L JacobsonOwner · (802) 332-6808
Enumeration DateApril 4, 2019
✔ NPI 1912469297 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.
42 TIMBER LN, South Burlington, VT 05403
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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.

KELLEY PHARMACY INC
Pharmacy
42 TIMBER LN
SOUTH BURLINGTON, VT 05403
Chittenden County (802) 864-0812

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 Green Mountain Pediatric Dentistry, PLLC's NPI number?

The NPI number for Green Mountain Pediatric Dentistry, PLLC is 1912469297. It was assigned to this organization in the NPPES registry on April 4, 2019.

Where is Green Mountain Pediatric Dentistry, PLLC located?

Green Mountain Pediatric Dentistry, PLLC is located at 42 Timber Ln, South Burlington, VT 05403. The listed phone number is (802) 332-6808.

What is Green Mountain 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 Green Mountain Pediatric Dentistry, PLLC was last updated on April 4, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.