Kerrville Pediatric Dentistry, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

24255 Issued in TX

Legal business name

KERRVILLE PEDIATRIC DENTISTRY, PLLC

Practice address

1700 Sidney Baker St
Suite #200
Kerrville, TX 78028-2654

Phone

(210) 632-4560

NPI assigned

Nov 6, 2014

Organization subpart

No

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

Authorized official

Name

Joanna Ayala, D.M.D.NPI 1730327578

Title

Managing Member

Phone

(210) 632-4560

Specialties & licenses 1

Addresses

Other names 1

• Tots to Teens Pediatric Dentistry Doing business as

Practitioners 1

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

• Joanna Cristine Ayala, D.M.D.

  • Pediatric Dentistry
  • Laredo, TX
  • NPI 1730327578
  NPD (past) Authorized official

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

{
    "created_epoch": "1415232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415232000000",
    "number": "1366848129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12016 EUCALYPTUS ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782453307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 SIDNEY BAKER ST",
            "address_2": "SUITE #200",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780282654",
            "telephone_number": "210-632-4560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERRVILLE PEDIATRIC DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-06",
        "last_updated": "2014-11-06",
        "status": "A",
        "authorized_official_last_name": "AYALA",
        "authorized_official_first_name": "JOANNA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "210-632-4560",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "24255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tots to Teens Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kerrville Mec, LP
• Kerrville Nursing and Rehab Center LLC
• Kerrville Operations LLC
• Kerrville Oral & Maxillofacial Surgery, P.a.
• Kerrville Orthodontics, PLLC
• Kerrville Pediatrics
• Kerrville Physical Therapy Center LLC
• Kerrville Physical Therapy Home Health Services
• Megan Kathleen Kester
• John Caleb Key, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2014; 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.