Kimi Dart, DO, PLLC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

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

Organization subpart

No

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

Authorized official

Name

Kimi Dart, MDNPI 1881887867

Title

Owner

Phone

(979) 258-5445

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimi L Dart, D.O.

  • Otolaryngology Physician
  • Lake Jackson, TX
  • NPI 1881887867

  Otolaryngology, TX

  Medicare reassignment NPD Authorized official

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": []
}

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• All providers in Lake Jackson, TX
• Otolaryngology Physician in Texas

• 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.

Verify at the official NPI Registry.