Kingdom Kids Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

KINGDOM KIDS DENTAL LLC

Practice address

3102 Prospect Ave
Kansas City, MO 64128-1559

Phone

(816) 674-9796

NPI assigned

Apr 24, 2024

Last updated

Apr 24, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Krista Shehan

Title

Vice President of Operations

Phone

(816) 674-9796

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1713916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713916800000",
    "number": "1023864824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 NW SHAGBARK ST",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640641447",
            "telephone_number": "816-674-9796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3102 PROSPECT AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641281559",
            "telephone_number": "816-674-9796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGDOM KIDS DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-24",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A",
        "authorized_official_last_name": "SHEHAN",
        "authorized_official_first_name": "KRISTA",
        "authorized_official_title_or_position": "VICE PRESIDENT OF OPERATIONS",
        "authorized_official_telephone_number": "816-674-9796"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy King
• Thomasa Shannel King
• Zackary King, MSW, LSW
• Kingdom Care Transport LLC
• Kingdom Home Care LLC
• Ryan Kingery, PHARM D
• Rae Ann Kingsley, APRN
• Kingswood Campus Opco LLC (Kingswood Senior Living)
• Kristin Kay Kinkade, LPC
• Gabrielle Kinnett

• General Practice Dentistry in Kansas City, MO
• Providers in Kansas City, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.