Kids Dentistree Of In, LLC
Dentist, Pediatric Dentistry in Scottsburg, IN. Organization (NPI-2).
NPI number1760048748
StatusActive
Last updated in NPPESSep 6, 2023
Details
- NPI
- 1760048748
- Entity type
- Organization (NPI-2)
- Legal business name
- Kids Dentistree Of In, LLC
- Organization subpart
- No
- Enumeration date
- May 15, 2019
- Certification date
- Sep 6, 2023
- Last updated
- Sep 6, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223P0221X | Dentist, Pediatric Dentistry | – | – | Yes |
Other names
- Kids Dentistree - Scottsburg (Doing Business As)
Practice location
1602 W McClain AveScottsburg, IN 47170-1161
Phone 502-254-8500
Mailing address
Po Box 437169Louisville, KY 40253-7169
Authorized official
Jeff Reibel
Cfo
5022548500
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