Kiwi Pediatric Dental Group PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

KIWI PEDIATRIC DENTAL GROUP PLLC

Practice address

17059 Stuebner Airline Rd
Spring, TX 77379

Phone

(281) 444-3999

Fax

(281) 444-8079

NPI assigned

Sep 16, 2013

Last updated

Nov 2, 2023By 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

Dr. Lisa Trevino, DDSNPI 1881918753

Title

Owner/Doctor

Phone

(281) 444-3999

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lisa Marie Trevino, DDS

  • Pediatric Dentistry
  • Spring, TX
  • NPI 1881918753
  NPD Authorized official
• Jerry Wayne Godkin, DDS MSD

  • Pediatric Dentistry
  • Spring, TX
  • NPI 1225253669
  NPD (past)
• Emma Chioma Adanma Kalu Onwuka, D.D.S.

  • Pediatric Dentistry
  • Spring, TX
  • NPI 1952615593
  NPD (past)

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

{
    "created_epoch": "1379289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698883200000",
    "number": "1417383969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17059 STUEBNER AIRLINE RD",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "77379",
            "telephone_number": "281-444-3999",
            "fax_number": "281-444-8079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17059 STUEBNER AIRLINE RD",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "77379",
            "telephone_number": "281-444-3999",
            "fax_number": "281-444-8079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIWI PEDIATRIC DENTAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-16",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A",
        "authorized_official_last_name": "TREVINO",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "281-444-3999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirby Creek Procedure Suite, LLC
• Olivia Kirby
• Kenneth Allen Kirk, DDS
• Kurt James Kirkpatrick, M.D.
• Eriana Jade Kirwin, OTD, OTR/L
• Richard Kizer
• Klein Chiropractic Clinic, P.C.
• Klein Crossing Dental, P.a.
• Klein Cypress Medical Clinic, P.a.
• Klein Dental Center, P.C. (Klein Dental Center)

• Pediatric Dentistry in Spring, TX
• Providers in Spring, 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 2, 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.