NPIMap

Organization Active NPI

Jennifer P. Ketchel, DDS, Ms, PA

  • Pediatric Dentistry
  • Arlington, TX
National Provider Identifier
1063786705
Registry record updated Jun 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
20274 Issued in TX
Legal business name
JENNIFER P. KETCHEL, DDS, MS, PA
Practice address
7410 S Cooper St Ste 100
Arlington, TX 76001-7025
Phone
(817) 465-0044
Fax
(817) 465-0055
NPI assigned
Feb 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2013

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

Authorized official

Name
Dr. Jennifer Pettit Ketchel, DDSNPI 1174689319
Title
Pediatric Dentist
Phone
(817) 465-0044

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 20274 TX Primary

Addresses

Primary practice location

7410 S Cooper St Ste 100
Arlington, TX 76001-7025

Mailing address

7410 S Cooper St Ste 100
Arlington, TX 76001-7025
Phone (817) 465-0044

Other names 1

  • Arlington Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

7410 S Cooper St
Ste 100
Arlington, TX 76001
Phone (817) 465-0044

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1330300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371513600000",
    "number": "1063786705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7410 S COOPER ST STE 100",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760017025",
            "telephone_number": "817-465-0044",
            "fax_number": "817-465-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7410 S COOPER ST STE 100",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760017025",
            "telephone_number": "817-465-0044",
            "fax_number": "817-465-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER P. KETCHEL, DDS, MS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-27",
        "last_updated": "2013-06-18",
        "status": "A",
        "authorized_official_last_name": "KETCHEL",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "PETTIT",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "817-465-0044",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "20274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arlington Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.

Verify at the official NPI Registry.