NPIMap

Organization Active NPI

Kids Pediatric Dentistry, PA

  • Pediatric Dentistry
  • Allen, TX
National Provider Identifier
1801101191
Registry record updated Aug 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
18425 Issued in TX
Legal business name
KIDS PEDIATRIC DENTISTRY, PA
Practice address
335 N Allen Dr
Allen, TX 75013-2539
Phone
(972) 727-0011
Fax
(972) 727-0707
NPI assigned
Aug 11, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2010

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

Authorized official

Name
Elisabeth Rowold-Garciamendez, D.D.S., M.S.NPI 1972632123
Title
Owner
Phone
(972) 727-0011

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 18425 TX Primary

Addresses

Primary practice location

335 N Allen Dr
Allen, TX 75013-2539

Mailing address

335 N Allen Dr
Allen, TX 75013-2539
Phone (972) 727-0011

Other identifiers 5

IdentifierTypeStateIssuer
0912743-02MedicaidTX
900-53478OtherALBCBS OF ALABAMA
0000ZBX696OtherMABCBS OF MA
85D713OtherTXBCBS OF TX
861423OtherTXUNITED CONCORDIA

National Provider Directory

National Provider Directory

Locations

335 N Allen Dr
Allen, TX 75013
Phone (972) 727-0011

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281484800000",
    "number": "1801101191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 N ALLEN DR",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750132539",
            "telephone_number": "972-727-0011",
            "fax_number": "972-727-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 N ALLEN DR",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750132539",
            "telephone_number": "972-727-0011",
            "fax_number": "972-727-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS PEDIATRIC DENTISTRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-11",
        "last_updated": "2010-08-11",
        "status": "A",
        "authorized_official_last_name": "ROWOLD-GARCIAMENDEZ",
        "authorized_official_first_name": "ELISABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-727-0011",
        "authorized_official_credential": "D.D.S., M.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "18425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0912743-02",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ALABAMA",
            "identifier": "900-53478",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MA",
            "identifier": "0000ZBX696",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TX",
            "identifier": "85D713",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "861423",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; 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.