Kidspace Pediatric Dentistry Partnership

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

KIDSPACE PEDIATRIC DENTISTRY PARTNERSHIP

Doing business as

Kidspace Pediatric Dentistry Partnership

Practice address

430 N Woodlawn St
Wichita, KS 67208-4300

Phone

(316) 684-2100

NPI assigned

Jan 23, 2023

Organization subpart

No

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

Authorized official

Name

Julie Le

Title

Practice Administrator

Phone

(316) 684-2100

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Kidspace Pediatric Dentistry Partnership Doing business as

Electronic endpoints 1

Locations

Practitioners 1

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

• Hoanh Ba Le, D.D.S

  • Pediatric Dentistry
  • Wichita, KS
  • NPI 1205891355
  NPD (past)

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674432000000",
    "number": "1407561590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 N WOODLAWN ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672084300",
            "telephone_number": "316-684-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 N WOODLAWN ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672084300",
            "telephone_number": "316-684-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDSPACE PEDIATRIC DENTISTRY PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "316-684-2100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30004579430004",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30004593990002",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30004575080002",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "frontdesk@kidspacedentistry.com",
            "affiliation": "N",
            "address_1": "430 N Woodlawn St",
            "city": "Wichita",
            "state": "KS",
            "country_code": "US",
            "postal_code": "672084300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Kidspace Pediatric Dentistry Partnership",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Monica Khurana
• Vijay Kumar Khurana, MD
• Cynthia Kibet, MD
• Kibigi Enterrprises and Oil LLC
• Veronica Kidd, DNAP
• Kidspace Pediatric Dentistry,P.a
• Caylee Kidwell Hinkle
• Bryce E Kidwell, DPT
• Kidz Cardiology, Inc
• Chung Kiefer, RN

• Pediatric Dentistry in Wichita, KS
• Providers in Wichita, KS by specialty
• Pediatric Dentistry in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; 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.