The Kids' Dentist, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

D3120PD Issued in ID

Legal business name

THE KIDS' DENTIST, PLLC

Practice address

2300 W Everest LN
Suite 125
Meridian, ID 83646-5925

Phone

(208) 938-6343

Fax

(208) 884-5048

NPI assigned

Mar 7, 2008

Last updated

Mar 7, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Lawrence Wayne Meadors, D.M.D.NPI 1962466292

Title

Owner/Member

Phone

(208) 938-6343

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lawrence Wayne Meadors, D.M.D.

  • Pediatric Dentistry
  • Meridian, ID
  • NPI 1962466292
  NPD (past) Authorized official
• Brock Coletti

  • Pediatric Dentistry
  • Meridian, ID
  • NPI 1720447097
  NPD (past)

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

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204848000000",
    "number": "1679743470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 W EVEREST LN",
            "address_2": "SUITE 125",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836465925",
            "telephone_number": "208-938-6343",
            "fax_number": "208-884-5048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 W EVEREST LN",
            "address_2": "SUITE 125",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836465925",
            "telephone_number": "208-938-6343",
            "fax_number": "208-884-5048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE KIDS' DENTIST, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-07",
        "last_updated": "2008-03-07",
        "status": "A",
        "authorized_official_last_name": "MEADORS",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "208-938-6343",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "ID",
            "license": "D3120PD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in Meridian, ID
• Providers in Meridian, ID by specialty
• Pediatric Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; 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.