Victoria Kids Dentistry PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

VICTORIA KIDS DENTISTRY PLLC

Doing business as

Dr. Wiedenfeld DDS- Children's Dentistry

Practice address

101 Professional Park Dr
Victoria, TX 77904-2351

Phone

(361) 578-8800

NPI assigned

Sep 5, 2017

Organization subpart

No

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

Authorized official

Name

Ms. Amanda Saiz

Title

Credentialing Specialist

Phone

(254) 338-1468

Specialties & licenses 1

Addresses

Other names 1

• Dr. Wiedenfeld DDS- Children's Dentistry Doing business as

Locations

Practitioners 2

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

• Shipra Sharma

  • Pediatric Dentistry
  • Victoria, TX
  • NPI 1275024838
  NPD
• Kenneth Ray Wiedenfeld, D.D.S.

  • Pediatric Dentistry
  • Victoria, TX
  • NPI 1568473189
  NPD (past)

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

{
    "created_epoch": "1504569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1861910341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PROFESSIONAL PARK DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779042351",
            "telephone_number": "361-578-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PROFESSIONAL PARK DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779042351",
            "telephone_number": "361-578-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORIA KIDS DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-05",
        "last_updated": "2022-07-21",
        "certification_date": "2019-12-16",
        "status": "A",
        "authorized_official_last_name": "SAIZ",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "254-338-1468",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Wiedenfeld DDS- Children's Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Victoria Hearing Center LLC
• Victoria Heart and Vascular Center, P.a.
• Victoria Hematology & Oncology Associates PA
• Victoria Independent School District
• Victoria Kidney & Dialysis Associates
• Victoria Medical & Rehabilitation Associates, P.a.
• Victoria Metro Anesthesia
• Victoria MRI LTD (Victoria Upright MRI)
• Victoria Nephrology Associates LLC
• Victoria NP Clinic PLLC

• Pediatric Dentistry in Victoria, TX
• Providers in Victoria, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.