The Kid's Dentist, P.a.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

THE KID'S DENTIST, P.A.

Practice address

7230 Lee Deforest Dr
Ste 107N
Columbia, MD 21046-3202

Phone

(443) 622-8908

Fax

(443) 819-1659

NPI assigned

Sep 14, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Nneka Davis, DMDNPI 1184868184

Title

Owner/Pediatric Dentist

Phone

(443) 622-8908

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bryaut The Kid's Dentist PA Former legal business name

Locations

Practitioners 2

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.

• Nneka Natasha Davis, D.M.D.

  • Pediatric Dentistry
  • Columbia, MD
  • NPI 1184868184
  NPD Authorized official
• John Selph, DMD

  • Pediatric Dentistry
  • Marion, NC
  • NPI 1649704867
  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709510400000",
    "number": "1487759361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7230 LEE DEFOREST DR",
            "address_2": "STE 107N",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210463202",
            "telephone_number": "443-622-8908",
            "fax_number": "443-819-1659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7230 LEE DEFOREST DR",
            "address_2": "STE 107N",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210463202",
            "telephone_number": "443-622-8908",
            "fax_number": "443-819-1659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE KID'S DENTIST, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2024-03-04",
        "certification_date": "2024-02-29",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "NNEKA",
        "authorized_official_title_or_position": "OWNER/PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "443-622-8908",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025585800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bryaut The Kid's Dentist PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Pediatric Dentistry in Columbia, MD
• Providers in Columbia, MD by specialty
• Pediatric Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.