NPIMap

Organization Active NPI

Pediatric Dentistry of Cedar Hill, P.L.L.C.

Doing business as Kids@Heart Pediatric Dentistry

  • Pediatric Dentistry
  • Cedar Hill, TX
National Provider Identifier
1205378650
Registry record updated Nov 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
25216 Issued in TX
Legal business name
PEDIATRIC DENTISTRY OF CEDAR HILL, P.L.L.C.
Doing business as
Kids@Heart Pediatric Dentistry
Practice address
450 N Highway 67
Ste 100
Cedar Hill, TX 75104-2135
Phone
(318) 268-2620
Fax
(866) 892-0774
NPI assigned
Nov 15, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2016

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

Authorized official

Name
Ashla Larenda Martin, DDSNPI 1871775635
Title
Owner
Phone
(318) 268-2620

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 25216 TX Primary

Addresses

Primary practice location

450 N Highway 67
Ste 100
Cedar Hill, TX 75104-2135

Mailing address

450 N Highway 67
Ste 100
Cedar Hill, TX 75104-2135
Phone (318) 268-2620

Other identifiers 1

IdentifierTypeStateIssuer
1871775635OtherTXNPI TYPE 1

Other names 1

  • Kids@Heart Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory

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": "1479168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479168000000",
    "number": "1205378650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 N HIGHWAY 67",
            "address_2": "STE 100",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751042135",
            "telephone_number": "318-268-2620",
            "fax_number": "866-892-0774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 N HIGHWAY 67",
            "address_2": "STE 100",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751042135",
            "telephone_number": "318-268-2620",
            "fax_number": "866-892-0774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTISTRY OF CEDAR HILL, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-15",
        "last_updated": "2016-11-15",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "ASHLA",
        "authorized_official_middle_name": "LARENDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-268-2620",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "25216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1871775635",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kids@Heart Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cedar Hill, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.