Lubbock Kids Dental PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

LUBBOCK KIDS DENTAL PLLC

Practice address

1504 Buddy Holly Ave
Lubbock, TX 79401-5131

Phone

(806) 749-5437

Fax

(806) 744-7241

NPI assigned

Dec 2, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Kay Kennel

Title

Ceo

Phone

(806) 438-4329

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Dietmar A Kennel, DDS

  • Pediatric Dentistry
  • Lubbock, TX
  • NPI 1013926955
  NPD (past)

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

{
    "created_epoch": "1322784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322784000000",
    "number": "1124396312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 BUDDY HOLLY AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794015131",
            "telephone_number": "806-749-5437",
            "fax_number": "806-744-7241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 BUDDY HOLLY AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794015131",
            "telephone_number": "806-749-5437",
            "fax_number": "806-744-7241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUBBOCK KIDS DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-02",
        "last_updated": "2011-12-02",
        "status": "A",
        "authorized_official_last_name": "KENNEL",
        "authorized_official_first_name": "KAY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "806-438-4329",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lubbock Integrative Medicine
• Lubbock Interventional Nephrology Associates PA
• Lubbock Isd
• Lubbock Kidney & Blood Pressure Clinic P a
• Lubbock Kidney and Blood Pressure Clinic PA
• Lubbock Lighthouse
• Lubbock Medical Associates
• Lubbock Minor Emergency Center Associates
• Lubbock Nephrology Associates, P.a.
• Lubbock Neurology, PLLC

• Pediatric Dentistry in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2011; 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.