Tatum L. Kinder, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS8105 Issued in TN

Practice address

1420 E Stone Dr
Suite G
Kingsport, TN 37660-4165

Phone

(423) 247-6961

Fax

(423) 247-5552

NPI assigned

Nov 9, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689744393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 E STONE DR",
            "address_2": "SUITE G",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604165",
            "telephone_number": "423-247-6961",
            "fax_number": "423-247-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 E STONE DR",
            "address_2": "SUITE G",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604165",
            "telephone_number": "423-247-6961",
            "fax_number": "423-247-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINDER",
        "first_name": "TATUM",
        "middle_name": "L.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS8105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TN",
            "identifier": "4065562",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taif Khattak, MD
• Lauren Amber Kidd, CRNA
• Shayla Atkins Kilgore, DNP
• Karen Sue Kimes, RN
• Adrienne Kincaid, PHARM.D.
• Drew Steven Kindle, DPT
• Matthew Bronson King
• Stacey Sheree King, PT
• Thomas P King, DDS MS
• Wanda King

• General Practice Dentistry in Kingsport, TN
• Providers in Kingsport, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.