Ikids Pediatric Dentistry Lakewood, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

IKIDS PEDIATRIC DENTISTRY LAKEWOOD, PLLC

Practice address

2011 Abrams Parkway
Dallas, TX 75214

Phone

(469) 581-9001

Fax

(469) 581-9002

NPI assigned

Jun 30, 2020

Last updated

Mar 4, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Alyssa N Aguilar

Title

Director of Revenue & Credentialing

Phone

(817) 466-8554

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614816000000",
    "number": "1316564990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 E BROAD ST STE 204",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760634361",
            "telephone_number": "817-466-8554",
            "fax_number": "682-273-0663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 ABRAMS PARKWAY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75214",
            "telephone_number": "469-581-9001",
            "fax_number": "469-581-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IKIDS PEDIATRIC DENTISTRY LAKEWOOD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-30",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A",
        "authorized_official_last_name": "AGUILAR",
        "authorized_official_first_name": "ALYSSA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE & CREDENTIALING",
        "authorized_official_telephone_number": "817-466-8554"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nkechi Ikediobi, PHARMD
• Ifeoma Ikedionwu
• Iyabode Bukola Ikejiora
• Catherine Minor Ikemba, MD
• James Chukwuma Ikemba, MD
• Micaela Amanda Ikner, NP
• Adaku Ikoh, DO
• Susan Ikome Enjema
• Ikonic Injury Center
• John Ikonomidis, MD

• Pediatric Dentistry in Dallas, TX
• Providers in Dallas, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; 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.