Jocelyn Denise Kidd, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

16582 Issued in TX

Practice address

8224 Park LN
Suite 125
Dallas, TX 75231-6011

Phone

(214) 987-1131

Fax

(214) 387-1012

NPI assigned

Apr 3, 2007

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 TX

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

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476403200000",
    "number": "1780705756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1168",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362021168",
            "telephone_number": "256-741-7340",
            "fax_number": "256-741-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8224 PARK LN",
            "address_2": "SUITE 125",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752316011",
            "telephone_number": "214-987-1131",
            "fax_number": "214-387-1012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDD",
        "first_name": "JOCELYN",
        "middle_name": "DENISE",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2016-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "16582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "329144501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ezana Kidane
• Milla Kidane
• Yordanos Ghebremicaheal Kidane, RPH
• Kidd Medical Concepts PLLC
• Avian D Kidd, M.D.
• Kimberly Kidd
• Mehgan Kidd, MD
• Michaela Angelea Kidd, CAA
• Mary Kidder, LCSW
• Kidney and Hypertension Associates of Dallas PLLC

• General Practice Dentistry in Dallas, TX
• Providers in Dallas, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2016; 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.