Kids Smile Innovations LLC

Primary specialty

DentistTaxonomy code 122300000X

License

12008126A Issued in IN

Legal business name

KIDS SMILE INNOVATIONS LLC

Doing business as

The Kid's Smile Place

Practice address

5129 Clinton Dr
Kokomo, IN 46902-7136

Phone

(765) 617-4750

NPI assigned

Dec 3, 2013

Organization subpart

No

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

Authorized official

Name

Ms. April D Spivey

Title

Practice Manager

Phone

(767) 617-4750

Specialties & licenses 1

Addresses

Other names 1

• The Kid's Smile Place Doing business as

Locations

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

{
    "created_epoch": "1386028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386028800000",
    "number": "1619308566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 SUMMERS DR",
            "city": "TIPTON",
            "state": "IN",
            "postal_code": "460728696",
            "telephone_number": "765-617-4750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5129 CLINTON DR",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469027136",
            "telephone_number": "765-617-4750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS SMILE INNOVATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-03",
        "last_updated": "2013-12-03",
        "status": "A",
        "authorized_official_last_name": "SPIVEY",
        "authorized_official_first_name": "APRIL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "767-617-4750",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12008126A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Kid's Smile Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joshua W Keyes, DPM
• Lindsay K Keyes, D.P.M.
• Rebecca Keyton
• Salman A Khan, M.D.
• Kasey Nicole Kidd, NP
• Kristen Kile, NP
• Misti Kilgore, RBT
• Shayla Killebrew
• Michelle Renee Killian, AGACNP
• Rebecca Anne Killingbeck-Smith, MA CCC-SLP

• Dentist in Kokomo, IN
• Providers in Kokomo, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2013; 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.