Kristofer Sivanich DDS PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

KRISTOFER SIVANICH DDS PLLC

Practice address

6750 Horizon Rd
Heath, TX 75032-2058

Phone

(469) 453-3055

Fax

(469) 453-3324

NPI assigned

Sep 20, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Kristofer Sivanich, DDSNPI 1285945089

Title

Owner

Phone

(469) 453-3055

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Kristofer Paul Sivanich, D.D.S.

  • Pediatric Dentistry
  • Fort Hood, TX
  • NPI 1285945089
  NPD Authorized official

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

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537401600000",
    "number": "1396229803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6750 HORIZON RD",
            "city": "HEATH",
            "state": "TX",
            "postal_code": "750322058",
            "telephone_number": "469-453-3055",
            "fax_number": "469-453-3324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6750 HORIZON RD",
            "city": "HEATH",
            "state": "TX",
            "postal_code": "750322058",
            "telephone_number": "469-453-3055",
            "fax_number": "469-453-3324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTOFER SIVANICH DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-20",
        "last_updated": "2018-09-20",
        "status": "A",
        "authorized_official_last_name": "SIVANICH",
        "authorized_official_first_name": "KRISTOFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-453-3055",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "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 TYPE 1",
            "identifier": "1285945089",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lee Ann Watkins Keeling, MD
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• Lanah Koh, DO
• Vineeth Kumar, MD
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• David B. Lensch, MD
• Les T. Sandknop, D.O. PA
• Lomah-Smith LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; 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.