KYLE PEDIATRIC DENTAL (NPI# 1679975932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679975932 |
| Entity Type | Organization |
| Organization Name | KYLE PEDIATRIC DENTAL |
| Other Organization Name | LONE STAR PEDIATRIC DENTAL |
| Practice Address |
575 E Fm 150 Suite P Kyle TX 78640-6200 |
| Mailing Address |
2700 S 1st St Austin TX 78704-5421 |
| Practice Telephone | 5124424338 |
| Mailing Telephone | 5124424338 |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2014-09-18 |
| Authorized Official Name | MARTY MONTGOMERY (PRESIDENT) |
| Authorized Official Telephone | 5125746923 |
| Authorized Official Credential | D.M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
24217 | TX | Dental Providers |
| Other Name | Type Code |
|---|---|
| Lone Star Pediatric Dental | Doing Business As Name - Organization |
| Street Address |
575 E FM 150 SUITE P |
| City | KYLE |
| State | TX |
| Zip Code | 78640-6200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558909853 | Advanced Spine & Wellness LLC | Chiropractor | 1101 Bunton Creek Rd., Ste. 330, Kyle, TX 78640 | 2019-12-17 |
| 1154962587 | Shelbi Hancock | Behavior Technician | 4221 Benner Road, Building 2, Suite 250, Kyle, TX 78640 | 2019-10-07 |
| 1326696469 | Robin Corina Dean | Physical Therapist | 21195b Ih35n Ste 201, Kyle, TX 78640 | 2019-09-02 |
| 1417503798 | Judson Sturdivant | Durable Medical Equipment & Medical Supplies | 1101 Bunton Creek Road, Kyle, TX 78640 | 2019-08-13 |
| 1063974152 | Fearless Functional Fitness, LLC | Physical Therapist | 140 Kirkham Circle, Kyle, TX 78640 | 2019-04-05 |
| 1639649197 | Virginia Vela | Nurse Practitioner | 180 Orion Cove, Kyle, TX 78640 | 2018-11-27 |
| 1033691878 | Keshavi Patel Pllc | Clinic/Center | 22510 Ih-35, Suite 104, Kyle, TX 78640 | 2018-08-29 |
| 1720564669 | Deborah Ann Burks | Massage Therapist | 147 Elmhurst Dr., 147 Elmhurst Dr. Ste 700, Kyle, TX 78640 | 2018-07-13 |
| 1689165995 | Daybreak Counseling Pllc | Counselor | 261 Mistletoe Ln, Kyle, TX 78640 | 2018-05-22 |
| 1194229179 | Amalia Belle Miller | Social Worker | 271 Hutton, Kyle, TX 78640 | 2018-03-22 |
| Find all providers in zip 78640 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598113953 | Kids Dental Works | Dentist | 1180 Seton Pkwy, Suite 425, Kyle, TX 78640-6178 | 2016-05-26 |
| 1588895692 | Children's Dentistry of Kyle | Dentist | 4100 Everett, Ste. 215, Kyle, TX 78640 | 2009-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326647454 | Memorial Dentistry for Kids Pllc | Dentist | 14090 Memorial Dr, Houston, TX 77079-6848 | 2020-10-20 |
| 1497362651 | Munal Dental Pllc | Dentist | 2921 N Fm 1417 Ste 100, Sherman, TX 75092-3559 | 2020-09-30 |
| 1467069880 | Unique Kids Pediatric Dentistry, Pllc | Dentist | 22118 Market Place Dr Ste 500, New Caney, TX 77357-2165 | 2020-09-29 |
| 1104438092 | Sarah Al Kukash | Dentist | 2536 Amherst St Ste A, Houston, TX 77005-3207 | 2020-08-20 |
| 1295344679 | Bulverde Dental Specialist Pllc | Dentist | 22103 Bulverde Rd Ste 108, San Antonio, TX 78259-1855 | 2020-07-30 |
| 1174132559 | Previcare, Pllc | Dentist | 2006 W Campbell Rd Ste 300, Garland, TX 75044-2315 | 2020-07-30 |
| 1386252088 | Saba Saleem Tareen | Dentist | 1503 Royal Ln, Colleyville, TX 76034-5585 | 2020-07-19 |
| 1306454178 | Susan Roberts Pediatric Dentistry Pllc | Dentist | 5411 Basswood Blvd Ste 201, Fort Worth, TX 76137-4479 | 2020-07-17 |
| 1316564990 | Ikids Pediatric Dentistry Lakewood, Pllc | Dentist | 2011 Abrams Parkway, Dallas, TX 75214 | 2020-06-30 |
| 1316563497 | Woodlands Pediatric Dentistry PC | Dentist | 4850 W Panther Creek Dr Ste 102, The Woodlands, TX 77381-3595 | 2020-06-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.