Randolph L. Kixmiller,DDS,PA

Primary specialty

DentistTaxonomy code 122300000X

License

103687 Issued in NC

Legal business name

RANDOLPH L. KIXMILLER,DDS,PA

Practice address

212 S Tryon St
#1502
Charlotte, NC 28281-0001

Phone

(704) 342-4014

NPI assigned

Feb 20, 2008

Last updated

Feb 20, 2008By 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

Dr. Randolph L Kixmiller, DDSNPI 1609955871

Title

Owner/President

Phone

(704) 342-4014

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Randolph Lewis Kixmiller, DDS

  • Dentist
  • Charlotte, NC
  • NPI 1609955871
  NPD (past) Authorized official

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203465600000",
    "number": "1336317601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 S TRYON ST",
            "address_2": "#1502",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282810001",
            "telephone_number": "704-342-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 S TRYON ST",
            "address_2": "#1502",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282810001",
            "telephone_number": "704-342-4014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDOLPH L. KIXMILLER,DDS,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-20",
        "last_updated": "2008-02-20",
        "status": "A",
        "authorized_official_last_name": "KIXMILLER",
        "authorized_official_first_name": "RANDOLPH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "704-342-4014",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "103687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaunda Rae Randleman, LCMHC
• Randolph Chiropractic Health Center PA
• Randolph Gardens Opco LLC (Randolph Gardens Health and Rehabilitation)
• Randolph Gardens SNF Operations LLC (Sherwood Health & Rehab)
• Randolph Internal Medicine Associates (Atrium Health Primary Care Randolph Internal Medicine)
• Nasir I Randolph-Powell, MSW, LCSWA
• Ashton Randolph
• Crystal Randolph, CCC-SLP
• Jala Randolph
• Jennifer Michelle Randolph, PHARM.D.

• Dentist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; 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.