Kid Dental Hospital Program LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

KID DENTAL HOSPITAL PROGRAM LLC

Practice address

3645 Warren Way
Reno, NV 89509-5241

Phone

(775) 825-5005

NPI assigned

Apr 22, 2021

Organization subpart

No

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

Authorized official

Name

Roy Delappe, DDS

Title

Owner Dentist

Phone

(775) 420-4400

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619049600000",
    "number": "1134701733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 W MOANA LN STE 14",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895094734",
            "telephone_number": "775-420-4400",
            "fax_number": "775-420-4776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3645 WARREN WAY",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895095241",
            "telephone_number": "775-825-5005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 N McCarran Blvd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Sparks",
            "state": "NV",
            "postal_code": "894313870",
            "country_code": "US",
            "telephone_number": "775-470-5070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18653 Wedge Pkwy Ste 170",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895113037",
            "country_code": "US",
            "telephone_number": "775-420-4400 x405",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1155 Mill St",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895021576",
            "country_code": "US",
            "telephone_number": "775-420-4400 x405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KID DENTAL HOSPITAL PROGRAM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A",
        "authorized_official_last_name": "DELAPPE",
        "authorized_official_first_name": "ROY",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "775-420-4400",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEVADA DENTAL BOARD",
            "identifier": "4833",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.kiddentalnv.com",
            "affiliation": "N",
            "endpointDescription": "Dental office",
            "address_1": "3645 Warren Way",
            "city": "Reno",
            "state": "NV",
            "country_code": "US",
            "postal_code": "895095241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Robert Khoury
• Rachel Khuc, PHARMD
• Aashish Khullar
• Anthony N Khuu, M.D.
• Sarah Zia Kiani, MD
• Kid Dental, LLC
• Haaben Tecle Kidane, RN
• Kiddos NV
• Kids First Family Services
• Kids Place 4 ABA, LLC

• Pediatric Dentistry in Reno, NV
• Providers in Reno, NV by specialty
• Pediatric Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; 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.