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.
| Specialty | Taxonomy Code | |
|---|---|---|
| * | Pediatric Dentistry | 1223P0221X |
| Dentist | 122300000X | |
| Student in an Organized Health Care Education/Training Program | 390200000X |
* Indicates primary specialty
| NPI Number | 1386164945 |
| Credentials | DMD (Doctor of Medical Dentistry) |
| Entity | Individual |
| Enumeration date | 06/26/2017 |
| Last updated | 01/30/2023 - About 3 years ago |
| Sole proprietor1 | No |
| Identifiers |
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| Hospital affiliation | n/a |
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.
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