Brent Douglas Kidd, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

9075 Issued in KY

Practice address

1275 Hallwood Drive
Morehead, KY 40351

Phone

(606) 784-8000

Fax

(606) 784-8004

NPI assigned

Apr 19, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Morehead Pediatric Dentistry, PLLC

  • Pediatric Dentistry
  • Morehead, KY
  • NPI 1326474099
  NPD Authorized official

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

{
    "created_epoch": "1303171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1255622692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 HALLWOOD DRIVE",
            "city": "MOREHEAD",
            "state": "KY",
            "postal_code": "40351",
            "telephone_number": "606-784-8000",
            "fax_number": "606-784-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 HALLWOOD DRIVE",
            "city": "MOREHEAD",
            "state": "KY",
            "postal_code": "40351",
            "telephone_number": "606-784-8000",
            "fax_number": "606-784-8004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDD",
        "first_name": "BRENT",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-19",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "9075",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "KY",
            "license": "9075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kentucky Eye Institute for Eye Health & Surgery
• Kentucky Institute for Eye Health & Surgery
• Kentucky Institute for Eye Health & Surgery
• Kentucky Medical Services Foundation
• Cindy Lee Kerns, CADC
• Donna Deirdre Kidwell, RN
• Mollie Brennin Kilgallin, PHARMD
• Ian Kinder, DO
• Haylee Renee King
• Ronald A Kline, MD

• Pediatric Dentistry in Morehead, KY
• Providers in Morehead, KY by specialty
• Pediatric Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; 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.