KDDS Dental PA

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

KDDS DENTAL PA

Doing business as

Innate Dental Solutions

Practice address

4708 W Plano Pkwy Ste 200
Plano, TX 75093-5335

Phone

(972) 519-0990

NPI assigned

Jul 19, 2023

Organization subpart

No

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

Authorized official

Name

Michelle Dossett

Title

Coo

Phone

(214) 557-7716

Specialties & licenses 1

Addresses

Other names 1

• Innate Dental Solutions Doing business as

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

{
    "created_epoch": "1689724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689724800000",
    "number": "1326728932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5228 VILLAGE CREEK DR STE 101",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750934431",
            "telephone_number": "972-519-0990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4708 W PLANO PKWY STE 200",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935335",
            "telephone_number": "972-519-0990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 Physicians Blvd Ste B",
            "address_purpose": "LOCATION",
            "city": "Ennis",
            "state": "TX",
            "postal_code": "751196248",
            "country_code": "US",
            "telephone_number": "972-945-0053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KDDS DENTAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-19",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A",
        "authorized_official_last_name": "DOSSETT",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "214-557-7716"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Innate Dental Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maftuna Kayumova, MD
• Mansoor Ahmed Kazi, FNP-C
• Syed Saad Kazmi
• KB Dental Plano P.a. (Southfork Dental)
• KD Beyer and Associates
• Kendall Elizabeth Keane, BCBA
• Michelle Kearby, MS, LPC
• Janna Kearns, PT
• Diana Margaret Kedora, FNP
• Kara Nicole Keegan, PT, DPT

• Dental Clinic/Center in Plano, TX
• Providers in Plano, TX by specialty
• Dental Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; 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.