Ikids Pediatric Dentistry Tyler, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

IKIDS PEDIATRIC DENTISTRY TYLER, PLLC

Practice address

3607 Old Jacksonville Rd
Tyler, TX 75701

Phone

(903) 595-5476

NPI assigned

Dec 27, 2017

Organization subpart

No

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

Authorized official

Name

Alyssa Aguilar

Title

Director of Revenue & Credentialing

Phone

(817) 466-8554

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• John David Carter, DMD

  • Pediatric Dentistry
  • Tyler, TX
  • NPI 1083707970
  NPD (past)

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

{
    "created_epoch": "1514332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614816000000",
    "number": "1699281782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 E BROAD ST STE 204",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760634361",
            "telephone_number": "817-466-8554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3607 OLD JACKSONVILLE RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75701",
            "telephone_number": "903-595-5476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IKIDS PEDIATRIC DENTISTRY TYLER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-27",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A",
        "authorized_official_last_name": "AGUILAR",
        "authorized_official_first_name": "ALYSSA",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE & CREDENTIALING",
        "authorized_official_telephone_number": "817-466-8554"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jose Luis Ibarra, OTR
• Richard D Idell, M.D.
• Steven Idell, MD
• Adebola Temitope Ifafore, M.D
• Cosmas Onyedika Ihezie, MD, CSFA
• Grace Effiong Imoh, RN
• Independent Anesthesia LLC
• Infucare, LTD
• Linda Ingham, RN
• Ashley Marie Ingledew

• Pediatric Dentistry in Tyler, TX
• Providers in Tyler, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.