OrganizationActive
Kids Dental Place
NPI 1093401101 · Pediatric Dentistry · Crestview, FL
Provider details
- NPI number
- 1093401101
- Entity type
- Organization
- Primary specialty
- Pediatric DentistryDental Providers
- Parent organization
- Kids Dental Place
- Organization subpart
- Yes
- Authorized official
- Rachel Witcher, Owner/Doctor(850) 477-1722
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(58/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
101 4th Ave Ste B
Crestview, FL 32539-2401
Phone: (850) 384-9171
Street-level locationGet directions
Mailing address
3201 E Olive Rd Ste B
Pensacola, FL 32514-7237
Other names (DBA / former)
- Doing business as
- Crestview Wild Smiles
Registry dates
- Enumerated
- 2023-04-12
- Last updated
- 2023-04-12
- Certified
- 2023-04-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.