NPIMap

Organization Active NPI

The Kid'S Dentist, PC

  • Pediatric Dentistry
  • Grand Prairie, TX
National Provider Identifier
1306084983
Registry record updated May 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
23641 Issued in TX
Legal business name
THE KID'S DENTIST, PC
Practice address
2337 S. Beltline Rd.
Ste 100
Grand Prairie, TX 75051
Phone
(972) 282-9444
Fax
(972) 282-9446
NPI assigned
Feb 4, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2016

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

Authorized official

Name
Joseph Anwah, DDSNPI 1023102522
Title
Director
Phone
(972) 282-9444

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)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 23641 TX Primary

Addresses

Primary practice location

2337 S. Beltline Rd.
Ste 100
Grand Prairie, TX 75051

Mailing address

2337 S. Beltline Rd.
Ste 100
Grand Prairie, TX 75051
Phone (972) 282-9444

Other identifiers 1

IdentifierTypeStateIssuer
284081101MedicaidTX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1233705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462406400000",
    "number": "1306084983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2337 S. BELTLINE RD.",
            "address_2": "STE 100",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "75051",
            "telephone_number": "972-282-9444",
            "fax_number": "972-282-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2337 S. BELTLINE RD.",
            "address_2": "STE 100",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "75051",
            "telephone_number": "972-282-9444",
            "fax_number": "972-282-9446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE KID'S DENTIST, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-04",
        "last_updated": "2016-05-05",
        "status": "A",
        "authorized_official_last_name": "ANWAH",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "972-282-9444",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "23641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "284081101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2016; 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.