Laura K. Kincannon, DDS, PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

27950 Issued in TX

Legal business name

LAURA K. KINCANNON, DDS, PLLC

Practice address

907 S Columbia Dr
West Columbia, TX 77486-3637

Phone

(979) 345-1451

NPI assigned

Sep 23, 2015

Last updated

Sep 23, 2015By 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

Laura Katherine Kincannon, DDSNPI 1982969242

Title

Owner

Phone

(979) 345-1451

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Laura K. Kincannon, DDS

  • General Practice Dentistry
  • West Columbia, TX
  • NPI 1982969242
  Authorized official Same address or phone

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

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442966400000",
    "number": "1801265566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 S COLUMBIA DR",
            "city": "WEST COLUMBIA",
            "state": "TX",
            "postal_code": "774863637",
            "telephone_number": "979-345-1451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 S COLUMBIA DR",
            "city": "WEST COLUMBIA",
            "state": "TX",
            "postal_code": "774863637",
            "telephone_number": "979-345-1451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURA K. KINCANNON, DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-23",
        "last_updated": "2015-09-23",
        "status": "A",
        "authorized_official_last_name": "KINCANNON",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "KATHERINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "979-345-1451",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "27950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982969242",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tony Wayne Kelsoe, DC
• Laura K. Kincannon, DDS
• Krenek Chiropractic (Palacios Chiropractic)
• Krenek Chiropractic (David Shane Krenek)
• David Shane Krenek, DC
• Roy L Ledbetter, DDS
• Boyang Lin, PHARMD
• Medical Leaders and Associates, PLLC
• Saloni Mehta
• Rebecca Moore

• Dentist in West Columbia, TX
• Providers in West Columbia, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; 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.