Active NPI
Kimi Dart, DO, PLLC
- Otolaryngology Physician
- Lake Jackson, TX
National Provider Identifier
1265017115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- Legal business name
- KIMI DART, DO, PLLC
- Practice address
- 215 Oak Dr S Ste E
Lake Jackson, TX 77566-5617 - Phone
- (979) 258-5445
- NPI assigned
- Mar 12, 2021
- Last updated
- Apr 23, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kimi Dart, MD
- Title
- Owner
- Phone
- (979) 258-5445
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | Primary |
Addresses
Primary practice location
215 Oak Dr S Ste E
Lake Jackson, TX 77566-5617
Mailing address
215 Oak Dr S Ste E
Lake Jackson, TX 77566-5617
Phone (979) 258-5445
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
215 Oak Dr S
Ste E
Lake Jackson, TX 77566
Phone (979) 258-5445
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Otolaryngology Physician
- Lake Jackson, TX
- NPI 1881887867
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615507200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1713830400000",
"number": "1265017115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 OAK DR S STE E",
"city": "LAKE JACKSON",
"state": "TX",
"postal_code": "775665617",
"telephone_number": "979-258-5445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 OAK DR S STE E",
"city": "LAKE JACKSON",
"state": "TX",
"postal_code": "775665617",
"telephone_number": "979-258-5445"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KIMI DART, DO, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-03-12",
"last_updated": "2024-04-23",
"certification_date": "2024-04-23",
"status": "A",
"authorized_official_last_name": "DART",
"authorized_official_first_name": "KIMI",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "979-258-5445",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Otolaryngology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lake Jackson, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.