SDC KL LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SDC KL LLC

Practice address

284 Tadpole LN
Taylorsville, NC 28681-8050

Phone

(704) 968-6791

NPI assigned

Mar 9, 2021

Last updated

Mar 9, 2021By 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

Katina R Cloud

Title

Manager

Phone

(704) 968-6791

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Practitioners 1

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.

• Erol J. Kanli, D.D.S.

  • Dentist
  • Springfield, VA
  • NPI 1457672420

  NC

  Medicare reassignment NPD

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

{
    "created_epoch": "1615248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615248000000",
    "number": "1790370997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 TADPOLE LN",
            "city": "TAYLORSVILLE",
            "state": "NC",
            "postal_code": "286818050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "284 TADPOLE LN",
            "city": "TAYLORSVILLE",
            "state": "NC",
            "postal_code": "286818050",
            "telephone_number": "704-968-6791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SDC KL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-09",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A",
        "authorized_official_last_name": "CLOUD",
        "authorized_official_first_name": "KATINA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "704-968-6791"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gail Lyon Roberts, FNP-BC
• Candace Rogers, LCSW
• Kellie Rough
• Shelby Schultz, LCSWA
• Scott S Smith DMD PA
• Robbie Sheffield, DMD
• Carson Brooke Sipe, LMT
• Stephen J Sladicka, MD
• Rebecca Ann Soltysiak, MS CCC SLP
• Moriah Armstrong Specht, NP-C

• Dental Clinic/Center in Taylorsville, NC
• Providers in Taylorsville, NC by specialty
• Dental Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.