NPIMap

Organization Active NPI

Dr. K's Pediatric Dentistry

  • Pediatric Dentistry
  • Palmer, AK
National Provider Identifier
1447619853
Registry record updated Feb 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
1578 Issued in AK
Legal business name
DR. K'S PEDIATRIC DENTISTRY
Practice address
1050 S Cobb St Unit a
Palmer, AK 99645-6916
Phone
(209) 242-3439
NPI assigned
Feb 12, 2016
Last updated
Feb 12, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2016

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

Authorized official

Name
Dr. Brian Anthony Kelleher, DDS
Title
Owner
Phone
(209) 242-3439

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 1578 AK Primary

Addresses

Primary practice location

1050 S Cobb St Unit a
Palmer, AK 99645-6916

Mailing address

1050 S Cobb St Unit a
Palmer, AK 99645-6916
Phone (209) 242-3439

National Provider Directory

National Provider Directory
Tax ID family
Dr K's Pediatric Dentistry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1455235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455235200000",
    "number": "1447619853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 S COBB ST UNIT A",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996456916",
            "telephone_number": "209-242-3439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 S COBB ST UNIT A",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996456916",
            "telephone_number": "209-242-3439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. K'S PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-12",
        "last_updated": "2016-02-12",
        "status": "A",
        "authorized_official_last_name": "KELLEHER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-242-3439",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AK",
            "license": "1578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmer, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2016; 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.