Individual provider Active NPI

Kiana Banon King, DMD

  • Dentist
  • Houston, TX
National Provider Identifier
1891360582
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
38638 Issued in TX
Practice address
1850 Fountain View Dr
Houston, TX 77057-3004
Phone
(713) 783-1095
NPI assigned
May 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 122670589923 UT
Dentist 122300000X 38638 TX Primary

Addresses

Primary practice location

1850 Fountain View Dr
Houston, TX 77057-3004

Mailing address

1206 Jackson Blvd Apt C
Houston, TX 77006-1274
Phone (281) 660-6399

Other names 1

  • Kiana Banon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221024001141 TX Order and Referring Only - DentistPractitioner - Dentist 6507232105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38638TXMDDentist
122670589923UTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Briargrove Smiles Dentistry, PC General Practice PastSince Aug 28, 2022 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1891360582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 JACKSON BLVD APT C",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770061274",
            "telephone_number": "281-660-6399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 FOUNTAIN VIEW DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770573004",
            "telephone_number": "713-783-1095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "KIANA",
        "middle_name": "BANON",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-25",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "122670589923",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "38638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIANA",
            "last_name": "BANON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.