Kid'S Zone Dentistry, LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

KID'S ZONE DENTISTRY, LLC

Practice address

307 Church St
Suite a
Lagrange, GA 30240-2700

Phone

(706) 882-0591

Fax

(706) 845-9546

NPI assigned

Mar 22, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Laura L Webb

Title

Office Manager

Phone

(706) 882-0591

Specialties & licenses 3

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458604800000",
    "number": "1073975868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 CHURCH ST",
            "address_2": "SUITE A",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302402700",
            "telephone_number": "706-882-0591",
            "fax_number": "706-845-9546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 CHURCH ST",
            "address_2": "SUITE A",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302402700",
            "telephone_number": "706-882-0591",
            "fax_number": "706-845-9546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KID'S ZONE DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-22",
        "last_updated": "2016-03-22",
        "status": "A",
        "authorized_official_last_name": "WEBB",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "706-882-0591",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN008745",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN014796",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000136848D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003148248A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "191678896B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Armstrong Kennedy, DMD
• John Herbert Kent Jr., DC
• Douglas Brent Kersey Jr., DMD
• Meredith Key, ED.S., LPC, NCC
• Kid Station Pediatrics P.C
• Kids Zone Behavioral Health, Inc
• Kids Zone Dentistry & Lagrange Family Dental
• James G Killebrew Jr., M.D.
• Jinah Kim
• Joo Young Kim, PHARMD

• Dentist in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2016; 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.