Kingman Dental Group

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

KINGMAN DENTAL GROUP

Practice address

1730 E Beverly Ave
Kingman, AZ 86409-3500

Phone

(928) 757-1707

Fax

(928) 757-3070

NPI assigned

Oct 17, 2018

Last updated

Oct 17, 2018By 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

Leighann Samson

Title

Manager

Phone

(928) 753-5069

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1539734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539734400000",
    "number": "1407322399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 E BEVERLY AVE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093500",
            "telephone_number": "928-757-1707",
            "fax_number": "928-757-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 E BEVERLY AVE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093500",
            "telephone_number": "928-757-1707",
            "fax_number": "928-757-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGMAN DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-17",
        "last_updated": "2018-10-17",
        "status": "A",
        "authorized_official_last_name": "SAMSON",
        "authorized_official_first_name": "LEIGHANN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "928-753-5069"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lewis Miller King III, BA
• Kingman Academy of Learning
• Kingman Behavioral Health LLC (Hickory Behavioral Center at Kingman)
• Kingman Cancer Center
• Kingman Chiropractic Clinic PC (Dennis D and Ryan D Gustafson DC)
• Kingman Dental Professionals, LLC
• Kingman Emergency Associates PLLC
• Kingman Family Dental Group LLC
• Kingman Family Dentistry
• Kingman Family Practice, P.C.

• General Practice Dentistry in Kingman, AZ
• Providers in Kingman, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.