KB Dental Group III, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12010486 Issued in IN

Legal business name

KB DENTAL GROUP III, LLC

Practice address

141 N Shortridge Rd
Indianapolis, IN 46219-8906

Phone

(317) 357-4018

NPI assigned

Nov 10, 2017

Organization subpart

No

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

Authorized official

Name

Ashley Coad

Title

Office Manager

Phone

(317) 570-5480

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.

• Samuel Bacon, D.D.S.

  • Dentist
  • Fishers, IN
  • NPI 1811070857
  NPD

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

{
    "created_epoch": "1510272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510272000000",
    "number": "1245743327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 N SHORTRIDGE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462198906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 N SHORTRIDGE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462198906",
            "telephone_number": "317-357-4018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KB DENTAL GROUP III, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-10",
        "last_updated": "2017-11-10",
        "status": "A",
        "authorized_official_last_name": "COAD",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "317-570-5480"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Allen Kazanjian, MS-LMFT
• Amir Saeed Kazi, M.D.
• Syed Kazmi, DO
• Mary Ann E Kazzi, LCSW
• KB Collection LLC (Krowned Beauty Collection)
• KB Dental, LLC (Simply Smile)
• KC Mental Health Counseling, LLC
• Kci USA Inc. (Solventum Advanced Wound Care)
• Amanda F Keafer, NP
• Sarah Mae Keaffaber, DPT

• General Practice Dentistry in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2017; 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.