NPIMap

Organization Active NPI

KDC Staples, PLLC

  • Pediatric Dentistry
  • Corpus Christi, TX
National Provider Identifier
1659966323
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
KDC STAPLES, PLLC
Practice address
5525 S Staples St Ste B4
Corpus Christi, TX 78411-5367
Phone
(361) 992-9500
Fax
(361) 992-1862
NPI assigned
Mar 4, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Authorized official

Name
Dr. Paul Alexander Kennedy III, DDSNPI 1376568469
Title
Owner/Doctor
Phone
(361) 992-9500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X
Public Health DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223D0001X
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X Primary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X

Addresses

Primary practice location

5525 S Staples St Ste B4
Corpus Christi, TX 78411-5367

Mailing address

6200 Saratoga Blvd BLDG 1
Corpus Christi, TX 78414-3477
Phone (361) 992-9500

Other practice location 1

80 N Woodlawn Dr
Alice, TX 78332-5000
Phone (361) 992-9500

National Provider Directory

National Provider Directory

Locations

80 N Woodlawn Dr
Alice, TX 78332
Phone (361) 664-3057

5525 S Staples St
Ste B4
Corpus Christi, TX 78411
Phone (361) 991-0008

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1614816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639526400000",
    "number": "1659966323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 SARATOGA BLVD BLDG 1",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784143477",
            "telephone_number": "361-992-9500",
            "fax_number": "361-992-1862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 S STAPLES ST STE B4",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784115367",
            "telephone_number": "361-992-9500",
            "fax_number": "361-992-1862"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 N Woodlawn Dr",
            "address_purpose": "LOCATION",
            "city": "Alice",
            "state": "TX",
            "postal_code": "783325000",
            "country_code": "US",
            "telephone_number": "361-992-9500",
            "fax_number": "361-992-1862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KDC STAPLES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-04",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "361-992-9500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.