Organization Active NPI

KDR Industries, PLLC

  • Pediatric Dentistry
  • Moline, IL
National Provider Identifier
1013878883
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
KDR INDUSTRIES, PLLC
Practice address
4530 12TH Ave
Moline, IL 61265-2552
Phone
(309) 797-3887
NPI assigned
Nov 20, 2025
Last updated
Nov 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Albert Yamoah, DDSNPI 1902239007
Title
Pediatric Dentist
Phone
(214) 455-4487

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

4530 12TH Ave
Moline, IL 61265-2552

Mailing address

4530 12TH Ave
Moline, IL 61265-2552
Phone (309) 797-3887

National Provider Directory

National Provider Directory

Locations

4530 12th Ave
Moline, IL 61265
Phone (309) 797-3887

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1763596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763596800000",
    "number": "1013878883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 12TH AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612652552",
            "telephone_number": "309-797-3887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4530 12TH AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612652552",
            "telephone_number": "309-797-3887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KDR INDUSTRIES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-20",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A",
        "authorized_official_last_name": "YAMOAH",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "214-455-4487",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moline, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.