Upper Valley Pediatric Dentistry, PC

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

03983 Issued in NH

Legal business name

UPPER VALLEY PEDIATRIC DENTISTRY, PC

Practice address

30 Airport Rd
Suite 7
West Lebanon, NH 03784-1664

Phone

(908) 892-2763

NPI assigned

Feb 10, 2015

Last updated

Apr 1, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Eileen Saunders, DMD

Title

Pediatric Dentist

Phone

(908) 892-2763

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1423526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427846400000",
    "number": "1225429335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 AIRPORT RD",
            "address_2": "SUITE 7",
            "city": "WEST LEBANON",
            "state": "NH",
            "postal_code": "037841664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 AIRPORT RD",
            "address_2": "SUITE 7",
            "city": "WEST LEBANON",
            "state": "NH",
            "postal_code": "037841664",
            "telephone_number": "908-892-2763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPPER VALLEY PEDIATRIC DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-10",
        "last_updated": "2015-04-01",
        "status": "A",
        "authorized_official_last_name": "SAUNDERS",
        "authorized_official_first_name": "EILEEN",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "908-892-2763",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "NH",
            "license": "03983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Center for Oral and Maxillofacial Surgery Professional Association
• Faithanna May Thibeault, LCMHC
• Kim Thompson
• Christian Derek Tsakiris
• Upper Valley Chiropractic PLLC
• Corrinne Vonkahle
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2138)
• Walgreen Co (Walgreens #09177)
• Angelica Ema Walsh, PA-C
• Cheryl Ann Waples, RPH

• Preferred Provider Organization in West Lebanon, NH
• Providers in West Lebanon, NH by specialty
• Preferred Provider Organization in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.