Active NPI
Zachary Ryan Kingsberg, D.M.D.
- Dentist
- Garland, TX
National Provider Identifier
1497138697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 31166
- Practice address
- 565 W Oates Rd Ste 150
Garland, TX 75043-5462 - Phone
- (214) 473-5696
- Fax
- (214) 602-5491
- NPI assigned
- Jul 7, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 31166 | TX | |
| Dentist | 122300000X | 31166 | TX | Primary |
Addresses
Primary practice location
565 W Oates Rd Ste 150
Garland, TX 75043-5462
Mailing address
565 W Oates Rd Ste 150
Garland, TX 75043-5462
Phone (214) 473-5696
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 346562723 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective May 14, 2016 through May 14, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31166 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| King Dental Partners PLLC | General Practice | Current | Accepting new patients |
| RFD Family Dentistry PLLC | General Practice | Current | Accepting new patients |
| Arts Family Dentistry PLLC | General Practice | Current | Accepting new patients |
| Falafulking Dental PLLC | General Practice | Past | Accepting new patients |
| Ac King Dental PLLC | General Practice | Past | Accepting new patients |
Locations
565 W Oates Rd
Ste 150
Garland, TX 75043
Phone (214) 473-5696
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638662400000",
"number": "1497138697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "565 W OATES RD STE 150",
"city": "GARLAND",
"state": "TX",
"postal_code": "750435462",
"telephone_number": "214-473-5696",
"fax_number": "214-602-5491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "565 W OATES RD STE 150",
"city": "GARLAND",
"state": "TX",
"postal_code": "750435462",
"telephone_number": "214-473-5696",
"fax_number": "214-602-5491"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINGSBERG",
"first_name": "ZACHARY",
"middle_name": "RYAN",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-07-07",
"last_updated": "2021-12-05",
"certification_date": "2021-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "31166",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "31166",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "346562723",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Garland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.