RWPK LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

25425 Issued in TX

Legal business name

RWPK LLC

Doing business as

Kerrville Pediatric Dentistry

Practice address

715 Hill Country Dr Ste 5
Kerrville, TX 78028-5965

Phone

(830) 255-4197

NPI assigned

Oct 19, 2015

Organization subpart

Yes

Parent organization

RWPK LLCAs reported in NPPES

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

Authorized official

Name

Rex Elwyn Wildey, DDS

Title

Owner

Phone

(830) 255-4197

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kerrville Pediatric Dentistry Doing business as

Tax ID family

RWPK PLLC2 organizations share this tax ID, including this one

Part of

RWPK PLLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• RWPK PLLC

  • Pediatric Dentistry
  • San Antonio, TX
  • NPI 1356762223
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• RWPK PLLC

  • Pediatric Dentistry
  • San Antonio, TX
  • NPI 1356762223
  NPPES parent name

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

{
    "created_epoch": "1445212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456790400000",
    "number": "1225409139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 HILL COUNTRY DR STE 5",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780285965",
            "telephone_number": "830-255-4197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 HILL COUNTRY DR STE 5",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780285965",
            "telephone_number": "830-255-4197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RWPK LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RWPK LLC",
        "enumeration_date": "2015-10-19",
        "last_updated": "2016-03-01",
        "status": "A",
        "authorized_official_last_name": "WILDEY",
        "authorized_official_first_name": "REX",
        "authorized_official_middle_name": "ELWYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "830-255-4197",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "25425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211746707",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kerrville Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sarah Rowe, FNP
• Michelle Marie Royer, RN
• Joseph Edward Rubio, PA
• David William Ruggles, OTD
• Christi Rose Rusch, LPC
• S-H Opco Plaza on the River, LLC
• S-H Opco Plaza on the River, LLC
• S-H Opco Plaza on the River, LLC
• Jean Saathoff
• Scott A Sachs, DDS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.