OrganizationActive
Bubble Gum Kids Dentistry
NPI 1790461630 · Pediatric Dentistry · Southgate, MI
Bubble Gum Kids Dentistry is a Pediatric Dentistry organization in Southgate, MI (NPI 1790461630).
Provider details
- NPI number
- 1790461630
- Entity type
- Organization
- Primary specialty
- Pediatric DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Amy Paundlay, Sr. Vice President of Operatopms(203) 400-9999
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
2 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
15401 Dix Toledo Rd
Southgate, MI 48195
Phone: (734) 999-9292
Fax: (734) 999-9393
Street-level locationGet directions
Mailing address
15401 Dix Toledo Rd
Southgate, MI 48195
Other names (DBA / former)
- Doing business as
- Bubble Gum Kids Dentistry
Registry dates
- Enumerated
- 2023-06-26
- Last updated
- 2023-06-26
- Certified
- 2023-06-26
Frequently asked questions
- What is Bubble Gum Kids Dentistry's NPI number?
- Bubble Gum Kids Dentistry's National Provider Identifier (NPI) is 1790461630, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Bubble Gum Kids Dentistry?
- Bubble Gum Kids Dentistry is classified in the NPPES registry as Pediatric Dentistry (Dental Providers).
- Where is Bubble Gum Kids Dentistry located?
- Bubble Gum Kids Dentistry's practice location on file with NPPES is 15401 Dix Toledo Rd, Southgate, MI 48195.
- What is Bubble Gum Kids Dentistry's phone number?
- The practice phone number listed in the NPPES registry for Bubble Gum Kids Dentistry is (734) 999-9292.
- Who is the authorized official for Bubble Gum Kids Dentistry?
- The authorized official listed on Bubble Gum Kids Dentistry's NPPES record is Amy Paundlay, Sr. Vice President of Operatopms. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Bubble Gum Kids Dentistry's NPI active?
- Yes — Bubble Gum Kids Dentistry's NPI (1790461630) is active in the NPPES registry as of the last update on 2023-06-26.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.