Active NPI
Kyle Minter Parks, D.M.D.
- Dentist
- Tuba City, AZ
National Provider Identifier
1003248899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6043
- Practice address
- 167 N Main St.
Tuba City, AZ 86045 - Phone
- (928) 283-2672
- NPI assigned
- Aug 2, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6043 | AL | Primary |
Addresses
Primary practice location
167 N Main St.
Tuba City, AZ 86045
Mailing address
4015 E Soliere Ave
Flagstaff, AZ 86004-7600
Phone (256) 345-5841
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6043 | AL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375401600000",
"number": "1003248899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4015 E SOLIERE AVE",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860047600",
"telephone_number": "256-345-5841"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "167 N MAIN ST.",
"city": "TUBA CITY",
"state": "AZ",
"postal_code": "86045",
"telephone_number": "928-283-2672"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKS",
"first_name": "KYLE",
"middle_name": "MINTER",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-08-02",
"last_updated": "2013-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AL",
"license": "6043",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tuba City, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.