KGC Dental, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22390 Issued in TX

Legal business name

KGC DENTAL, PLLC

Practice address

201 University Oaks
770
Round Rock, TX 78665-2422

Phone

(512) 579-0069

NPI assigned

Oct 19, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Kevin Kim, DDSNPI 1346468618

Title

Owner/Ceo

Phone

(512) 903-2899

Specialties & licenses 1

Addresses

Other names 1

• NUYU DENTAL Doing business as

Practitioners 2

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

• Kevin Kim, DDS

  • Dentist
  • Norco, CA
  • NPI 1346468618
  NPD (past) Authorized official
• Tarana H Chhatriwala, DDS

  • General Practice Dentistry
  • Torrington, CT
  • NPI 1093703431
  NPD (past)

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

{
    "created_epoch": "1350604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350604800000",
    "number": "1609129204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 UNIVERSITY OAKS",
            "address_2": "770",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786652422",
            "telephone_number": "512-579-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 UNIVERSITY OAKS",
            "address_2": "770",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786652422",
            "telephone_number": "512-579-0069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KGC DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-19",
        "last_updated": "2012-10-19",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "512-903-2899",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "22390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NUYU DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mahlon Alder Kerr, MD
• Christine Kessel
• Sally Kettler, RN
• Tilly K Keung
• Keytex Physical Therapy LLC
• Khan Rd
• Adnan Khan, MD
• Kamran Khan, RD
• Muhammad Ali Khan, M.D.
• Shamima Sultana Khan, M.D.

• General Practice Dentistry in Round Rock, TX
• Providers in Round Rock, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; 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.