Frisco Dentistry for Kids

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

FRISCO DENTISTRY FOR KIDS

Practice address

8380 Warren Pkwy
Ste 400
Frisco, TX 75034-4198

Phone

(214) 387-0099

NPI assigned

Aug 9, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Kelli L Ettelbrick, D.D.S., M.S.NPI 1578505038

Title

Partner

Phone

(214) 387-0099

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 3

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

• Kelli L Ettelbrick, D.D.S., M.S.

  • Pediatric Dentistry
  • Frisco, TX
  • NPI 1578505038
  NPD (past) Authorized official
• Kathryn Norbo Chuchla, DDS

  • Pediatric Dentistry
  • Dallas, TX
  • NPI 1306333455
  NPD (past)
• Ty A Hinze, D.D.S.

  • Pediatric Dentistry
  • Frisco, TX
  • NPI 1639364797
  NPD (past)

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

{
    "created_epoch": "1344470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344470400000",
    "number": "1346597390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8380 WARREN PKWY",
            "address_2": "STE 400",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750344198",
            "telephone_number": "214-387-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8380 WARREN PKWY",
            "address_2": "STE 400",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750344198",
            "telephone_number": "214-387-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRISCO DENTISTRY FOR KIDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-09",
        "last_updated": "2012-08-09",
        "status": "A",
        "authorized_official_last_name": "ETTELBRICK",
        "authorized_official_first_name": "KELLI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "214-387-0099",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI - INDIVIDUAL",
            "identifier": "1578505038",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI - INDIVIDUAL",
            "identifier": "1639364797",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frisco Custer Star Dental Group, PC (Custer Star Dental Group)
• Frisco Dental Associates
• Frisco Dental Health Center
• Frisco Dental Implant Center PLLC (Frisco Dental Implant Center)
• Frisco Dental Smiles PLLC (Active Dental Frisco)
• Frisco Dermatology Associates (Rodgers Dermatology)
• Frisco Diagnostic Imaging, LLC
• Frisco DNT Eldorado Medical Center
• Frisco Emergency Medicine Associates, PA
• Frisco Emergency Physicians PLLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; 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.