NPIMap

Organization Active NPI

Pediatric Dental Specialists

  • Pediatric Dentistry
  • Billings, MT
National Provider Identifier
1730209974
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
1797 Issued in MT
Legal business name
PEDIATRIC DENTAL SPECIALISTS
Practice address
2700 Grand Ave
Suite B
Billings, MT 59102-2680
Phone
(406) 652-5550
NPI assigned
Mar 30, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kelly ClarkeNPI 1285739409
Title
Dentist
Phone
(406) 652-5550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 1797 MT Primary

Addresses

Primary practice location

2700 Grand Ave
Suite B
Billings, MT 59102-2680

Mailing address

2700 Grand Ave
Suite B
Billings, MT 59102-2680
Phone (406) 652-5550

National Provider Directory

National Provider Directory

Locations

2700 Grand Ave
Ste B
Billings, MT 59102
Phone (406) 652-5550

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730209974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 GRAND AVE",
            "address_2": "SUITE B",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591022680",
            "telephone_number": "406-652-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 GRAND AVE",
            "address_2": "SUITE B",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591022680",
            "telephone_number": "406-652-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTAL SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "406-652-5550"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MT",
            "license": "1797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Billings, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.