Kool Smiles

Primary specialty

DentistTaxonomy code 122300000X

License

6698 Issued in LA

Legal business name

KOOL SMILES

Practice address

3719 Jewella Ave
Shreveport, LA 71109-4703

Phone

(318) 759-0905

NPI assigned

Jul 29, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Jessie Dixon, DDS

Title

General Dentist

Phone

(678) 285-4807

Specialties & licenses 1

Addresses

Other names 1

• UAB hospital Other name

Locations

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

{
    "created_epoch": "1469750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469750400000",
    "number": "1679026264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3719 JEWELLA AVE,",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71109",
            "telephone_number": "318-573-9918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3719 JEWELLA AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711094703",
            "telephone_number": "318-759-0905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOOL SMILES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-29",
        "last_updated": "2016-07-29",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "678-285-4807",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "LA",
            "license": "6698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UAB hospital",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ashok R Kompelli, MD
• Cynthia Shilpa Kondapaneni, MD
• Sai Konduru, MD
• Jaahnavi Konidala, MD
• Winston Koo, MD, MBBS
• Satya Priya Koppada
• Spencer Kortum
• Jennifer Elizabeth Koruna, BS
• Smit Rajeshkumar Kotadiya
• Vanitha Dorairajan Kothapalli, MD

• Dentist in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Dentist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2016; 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.