Dynamic Behavioral Healthcare Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

DYNAMIC BEHAVIORAL HEALTHCARE SERVICES

Practice address

2743 Kenedy LN
Grand Prairie, TX 75052-0735

Phone

(817) 235-8869

NPI assigned

Feb 6, 2023

Last updated

Sep 15, 2023By 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

Mr. Dickson D Oyeyemi-Kuteyi

Title

Owner

Phone

(817) 235-8869

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1675641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694736000000",
    "number": "1801592308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2743 KENEDY LN",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750520735",
            "telephone_number": "817-235-8869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2743 KENEDY LN",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750520735",
            "telephone_number": "817-235-8869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC BEHAVIORAL HEALTHCARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-06",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A",
        "authorized_official_last_name": "OYEYEMI-KUTEYI",
        "authorized_official_first_name": "DICKSON",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-235-8869",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "464166401",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "467418601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; 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.