Kyle R Childers DMD Ms PC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

KYLE R CHILDERS DMD MS PC

Practice address

201 W Washington St
Benton, IL 62812

Phone

(618) 438-2815

Fax

(618) 439-6127

NPI assigned

Feb 12, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kyle Ray Childers, DMD MSNPI 1699914762

Title

Owner

Phone

(618) 438-2815

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kyle R Childers, DMD, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Benton, IL
  • NPI 1699914762
  NPD (past) Authorized official

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497897284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W WASHINGTON ST",
            "city": "BENTON",
            "state": "IL",
            "postal_code": "62812",
            "telephone_number": "618-438-2815",
            "fax_number": "618-439-6127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W WASHINGTON ST",
            "city": "BENTON",
            "state": "IL",
            "postal_code": "62812",
            "telephone_number": "618-438-2815",
            "fax_number": "618-439-6127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KYLE R CHILDERS DMD MS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHILDERS",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-438-2815",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD MS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Kirkpatrick, PHARMD
• Logan Edward Kirkpatrick, RN
• Luke William Koehn, D.C.
• Melissa A Kramer, MS, CCC-SLP
• Kyle Childers Specialty Partners of Illinois, PLLC
• Robin S Labuwi, D.M.D,
• Ralph I Latta, MD
• Randall Wayne Lawrence, PT
• Cindy L Lord, FNP
• Mackmalter Enterprises Inc (Alpha Home Health Care)

• Orthodontics and Dentofacial Orthopedics Dentistry in Benton, IL
• Providers in Benton, IL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Illinois

• 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.