Individual provider Active NPI

Jennifer Ann Kunkel, DDS

  • General Practice Dentistry
  • Needville, TX
National Provider Identifier
1851453815
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20204 Issued in TX
Practice address
12815 Highway 36
Needville, TX 77461-8112
Phone
(979) 793-5566
NPI assigned
Dec 15, 2006
Last updated
May 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 20204 TX Primary

Addresses

Primary practice location

12815 Highway 36
Needville, TX 77461-8112

Mailing address

PO Box 1627
Needville, TX 77461-1627
Phone (979) 793-5566

Other identifiers 1

IdentifierTypeStateIssuer
1327462OtherTXUNITED CONCORIDA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
20204TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Needville Family Dentistry, PLLC General Practice CurrentSince May 24, 2020 Accepting new patients

Locations

12815 Highway 36
Needville, TX 77461
Phone (979) 793-5566

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1851453815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1627",
            "city": "NEEDVILLE",
            "state": "TX",
            "postal_code": "774611627",
            "telephone_number": "979-793-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12815 HIGHWAY 36",
            "city": "NEEDVILLE",
            "state": "TX",
            "postal_code": "774618112",
            "telephone_number": "979-793-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNKEL",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "20204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORIDA",
            "identifier": "1327462",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Needville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; 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.