Kaci L. Tibbetts, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

26455 Issued in TX

Practice address

3223 Thousand Oaks Dr Ste 102
San Antonio, TX 78247-3573

Phone

(210) 496-5422

Fax

(210) 490-2388

NPI assigned

Dec 2, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• KLT Dentistry PLLC

  • Dentist
  • San Antonio, TX
  • NPI 1093068744
  NPD (past) Authorized official

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

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609113600000",
    "number": "1861794430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7703 FLOYD CURL DRIVE UT HEALTH SCIENCE CENTER AT SAN A",
            "address_2": "MSC 7914, DEPT OF COMPREHENSIVE DENTISTRY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293900",
            "telephone_number": "210-567-3456",
            "fax_number": "210-567-3443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3223 THOUSAND OAKS DR STE 102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782473573",
            "telephone_number": "210-496-5422",
            "fax_number": "210-490-2388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBBETTS",
        "first_name": "KACI",
        "middle_name": "L.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-02",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "26455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles S Thurston, MD
• Thusu Family Dentistry PLLC
• Akshay Thusu, D.D.S.
• Shaimaa Tiabi, RBT
• Maria Magdalena Tiamson-Beato, MD
• Todd Austin Tibbetts, M.D., PH.D.
• Sandra D Tibbits
• Nathalie Rose Tiberio, M.D.
• Tiblier Legacy, LLC
• Diane Tice

• General Practice Dentistry in San Antonio, TX
• Providers in San Antonio, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2020; 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.