Phillip D Kothmann DDS Ms Inc

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

11462 Issued in TX

Legal business name

PHILLIP D KOTHMANN DDS MS INC

Practice address

4337 College Hills Blvd
San Angelo, TX 76904

Phone

(325) 942-9673

Fax

(325) 942-0369

NPI assigned

Aug 22, 2006

Organization subpart

No

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

Authorized official

Name

Phillip Dwight Kothmann, DDS MS

Title

President of Corporation

Phone

(325) 942-9673

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447366323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4337 COLLEGE HILLS BLVD",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "76904",
            "telephone_number": "325-942-9673",
            "fax_number": "325-942-0369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4337 COLLEGE HILLS BLVD",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "76904",
            "telephone_number": "325-942-9673",
            "fax_number": "325-942-0369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIP D KOTHMANN DDS MS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOTHMANN",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "DWIGHT",
        "authorized_official_title_or_position": "PRESIDENT OF CORPORATION",
        "authorized_official_telephone_number": "325-942-9673",
        "authorized_official_credential": "DDS MS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "11462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randhi Wijekularatne Peterson, MD
• Timothy Peterson, M.D.
• Amanda Petterson, CPHT
• Larry D. Petty, MD
• Amy Lin Pfluger, LCSW
• Gary P Phillips, MD
• Sarah Pierce
• Thuduras Piert
• Mary A Pilsitz, LPC, LCDC
• Hector Pineda, LCSW

• Orthodontics and Dentofacial Orthopedics Dentistry in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.