IKIDS PEDIATRIC DENTISTRY ENNIS, PLLC (NPI# 1952806085) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952806085 |
| Entity Type | Organization |
| Organization Name | IKIDS PEDIATRIC DENTISTRY ENNIS, PLLC |
| Practice Address |
711 S Clay St Ste A Ennis TX 75119 |
| Mailing Address |
2500 E Broad St Ste 104 Mansfield TX 76063-4181 |
| Practice Telephone | 6822221010 |
| Mailing Telephone | 8174668554 |
| Mailing Fax Number | 8174667449 |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2019-06-11 |
| Authorized Official Name | ALYSSA AGUILAR (DIRECTOR OF REVENUE & CREDENTIALING) |
| Authorized Official Telephone | 8174668554 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers | ||
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Street Address |
711 S CLAY ST STE A |
| City | ENNIS |
| State | TX |
| Zip Code | 75119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174121859 | Alexandria Etuk | Pharmacist | 101 Sh-437 Spur, Ennis, TX 75119 | 2020-10-14 |
| 1285279158 | Oluchi Ozumba Md Pa | Pain Medicine | 601 S Cly St, Suite 104, Ennis, TX 75119 | 2019-11-14 |
| 1609382068 | Living Single LLC | Residential Treatment Facility, Physical Disabilities | 809 E. Denton Street, Ennis, TX 75119 | 2017-12-21 |
| 1912363300 | Erin Denise Jackson | Counselor | 219 W. Brown St, Suite A, Ennis, TX 75119 | 2016-01-14 |
| 1164769139 | Matthew Garrett Cooper | Nurse Anesthetist, Certified Registered | 2201 W. Lampasas Street, Ennis, TX 75119 | 2013-01-11 |
| 1922343805 | Braces R Us PC | Dentist | 1012 E. Ennis Ave. Ste. C, Ennis, TX 75119 | 2012-12-04 |
| 1154684355 | Stefanie Nicole Rust | Emergency Medicine | 2201 West Lampasas Street, Ennis, TX 75119 | 2012-06-21 |
| 1265710909 | Traditions Health Care of Ennis, LLC | Home Health | 109 Southwest Main Street, Suite A, Ennis, TX 75119 | 2011-07-29 |
| 1578792370 | Peak Physical Therapy and Rehabilitation LLC | Physical Therapist | 2200 Physicians Blvd, Ste D, Ennis, TX 75119 | 2009-07-14 |
| 1942453691 | Ronald T. Oglesby, D.d.s. | Dentist | 900 W. Ennis Ave., Suite 105, Ennis, TX 75119 | 2008-10-28 |
| Find all providers in zip 75119 | ||||
| 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 |
|---|---|---|---|---|
| 1629344239 | Just for Kids Dental Ennis | Dentist | 711 S Clay St, Ennis, TX 75119-5748 | 2012-03-28 |
| 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.