Active NPI
Kendra Lynn Sandoval, D,M.D
- General Practice Dentistry
- Austin, TX
National Provider Identifier
1295090090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 28152
- Practice address
- 1201 E Cesar Chavez St
Austin, TX 78702-4332 - Phone
- (512) 477-2319
- NPI assigned
- Jul 8, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 28152 | TX | Primary |
Addresses
Primary practice location
1201 E Cesar Chavez St
Austin, TX 78702-4332
Mailing address
2 Redbud CV
West Lake Hills, TX 78746-4323
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28152 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343779200000",
"number": "1295090090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 REDBUD CV",
"city": "WEST LAKE HILLS",
"state": "TX",
"postal_code": "787464323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 E CESAR CHAVEZ ST",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787024332",
"telephone_number": "512-477-2319"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDOVAL",
"first_name": "KENDRA",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "D,M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-08",
"last_updated": "2012-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "28152",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.