The Kenedy Dentist, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

THE KENEDY DENTIST, PLLC

Practice address

131 Business Park Blvd Ste 600
Kenedy, TX 78119-3512

Phone

(972) 838-3772

NPI assigned

Dec 17, 2024

Last updated

Dec 17, 2024By 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. Maxim Mossman, DDSNPI 1386193373

Title

Owner

Phone

(972) 838-3772

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Maxim Mossman, DDS

  • General Practice Dentistry
  • Richardson, TX
  • NPI 1386193373
  Authorized official Same address or phone

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

{
    "created_epoch": "1734393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734393600000",
    "number": "1417764937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 195487",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752198608",
            "telephone_number": "972-838-3772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 BUSINESS PARK BLVD STE 600",
            "city": "KENEDY",
            "state": "TX",
            "postal_code": "781193512",
            "telephone_number": "972-838-3772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE KENEDY DENTIST, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-17",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A",
        "authorized_official_last_name": "MOSSMAN",
        "authorized_official_first_name": "MAXIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-838-3772",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Slayden
• Lori Lynn Smith, PHARMD
• Pricilla Dawn St.John-Hartsfield, LPC
• Steve C Steger, O.D.
• Steve C. Steger O.D.
• The Podiatry Group of South Texas, PA
• Jochelle Pawelek Uriegas, FNP-C
• Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-0524)
• Charles White, D.P.M.
• Robyn Elisabeth White

• Dental Clinic/Center in Kenedy, TX
• Providers in Kenedy, TX by specialty
• Dental Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; 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.