Jamal Alexander Kussad, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

016.0133972 Issued in VT

Practice address

282 Pinehurst St
Lyndonville, VT 05851

Phone

(802) 427-3323

Fax

(802) 427-3332

NPI assigned

Nov 28, 2006

Last updated

Jun 6, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Valley Dental Care PLLC

  dba Valley Dental Care

  • Dental Clinic/Center
  • El Paso, TX
  • NPI 1982399440
  NPD (past)

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1073689204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 85",
            "city": "LYNDONVILLE",
            "state": "VT",
            "postal_code": "058510085",
            "telephone_number": "802-427-3323",
            "fax_number": "802-427-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 PINEHURST ST",
            "city": "LYNDONVILLE",
            "state": "VT",
            "postal_code": "05851",
            "telephone_number": "802-427-3323",
            "fax_number": "802-427-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSSAD",
        "first_name": "JAMAL",
        "middle_name": "ALEXANDER",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2022-06-06",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "21855",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VT",
            "license": "016.0133972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6708822",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ID NUMBER",
            "identifier": "1073689204",
            "state": "VT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.kingdomdds.com/",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "282 Pinehurst St",
            "city": "Lyndonville",
            "state": "VT",
            "country_code": "US",
            "postal_code": "05851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kate T. Kearnan, MSW
• Kingdom East Unified Union School District
• KPH Healthcare Services, Inc. (Kinney Drugs #94)
• Logan Samuel Krass
• Kristi Zola, PLLC
• Michelle Laferriere, SLP-CCC
• Krista Laramee, DPT
• Kaitlin A Latta, PHARMD
• Brianna Nicole Lazzaro
• Deborah Lee, LADC

• General Practice Dentistry in Lyndonville, VT
• Providers in Lyndonville, VT by specialty
• General Practice Dentistry in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; 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.