Individual provider Active NPI

Kaitlyn Hodges, DDS

  • Pediatric Dentistry
  • Highland Village, TX
National Provider Identifier
1336705250
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
37253 Issued in TX
Practice address
2300 Village Pkwy
Highland Village, TX 75077-3322
Phone
(972) 845-8727
NPI assigned
May 15, 2019
Last updated
Apr 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Dentistry 1223P0221X 37253 TX Primary

Addresses

Primary practice location

2300 Village Pkwy
Highland Village, TX 75077-3322

Mailing address

5418 Vanderbilt Ave
Dallas, TX 75206-6024
Phone (901) 573-3261

Other practice location 1

501 S Stemmons Fwy
Lewisville, TX 75067-4562
Phone (972) 436-9121

Other practice location 2

321 N Grand Ave
Gainesville, TX 76240-4321
Phone (940) 665-0700

Other practice location 3

2109 W University Dr
Denton, TX 76201-0645
Phone (940) 484-5437

Other names 1

  • Kaitlyn Chambers Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190715003157 TN Order and Referring Only - DentistPractitioner - Dentist 0941535843

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37253TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
North Texas Children's Dentistry, PLLC Pediatric Dentistry Past Accepting new patients
North Texas Orthodontics, PLLC Past Accepting new patients
North Texas Pediatric and Orthodontics, PLLC Pediatric Dentistry PastSince Jan 15, 2023 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1557878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1336705250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5418 VANDERBILT AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752066024",
            "telephone_number": "901-573-3261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 VILLAGE PKWY",
            "city": "HIGHLAND VILLAGE",
            "state": "TX",
            "postal_code": "750773322",
            "telephone_number": "972-845-8727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 S Stemmons Fwy",
            "address_purpose": "LOCATION",
            "city": "Lewisville",
            "state": "TX",
            "postal_code": "750674562",
            "country_code": "US",
            "telephone_number": "972-436-9121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "321 N Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "TX",
            "postal_code": "762404321",
            "country_code": "US",
            "telephone_number": "940-665-0700",
            "fax_number": "940-612-0727",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2109 W University Dr",
            "address_purpose": "LOCATION",
            "city": "Denton",
            "state": "TX",
            "postal_code": "762010645",
            "country_code": "US",
            "telephone_number": "940-484-5437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HODGES",
        "first_name": "KAITLYN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-15",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "37253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLYN",
            "last_name": "CHAMBERS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Highland Village, TX

Sources for this page

Verify at the official NPI Registry.