Provider Demographics
NPI:1932990157
Name:COLUMBUS PEDIATRIC DENTISTRY, LLC
Entity type:Organization
Organization Name:COLUMBUS PEDIATRIC DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:
Authorized Official - First Name:KAITLYNN
Authorized Official - Middle Name:L
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-520-9765
Mailing Address - Street 1:8374 HILLSIDE PLZ
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-7327
Mailing Address - Country:US
Mailing Address - Phone:308-520-9765
Mailing Address - Fax:
Practice Address - Street 1:3005 19TH ST STE 700
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-4248
Practice Address - Country:US
Practice Address - Phone:402-585-0001
Practice Address - Fax:402-585-0504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty