NPIMap

Organization Active NPI

Kodp PLLC

  • Pediatric Dentistry
  • Gainesville, FL
National Provider Identifier
1902798903
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
KODP PLLC
Doing business as
Kid Only Dental Place
Practice address
5209 SW 91St Dr
Gainesville, FL 32608-3028
Phone
(352) 335-7777
Fax
(352) 727-4066
NPI assigned
Jul 16, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Authorized official

Name
Dr. Alicia Jessica Moore, DDSNPI 1629363452
Title
Pediatric Dentist
Phone
(352) 335-7777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

5209 SW 91St Dr
Gainesville, FL 32608-3028

Mailing address

5209 SW 91St Dr
Gainesville, FL 32608-3028
Phone (352) 335-7777

Other practice location 1

4910 NW 27th Ct
Gainesville, FL 32606-6590
Phone (352) 335-7777 ext. 2

Other names 1

  • Kid Only Dental Place Doing business as

National Provider Directory

National Provider Directory

Locations

5209 SW 91st Dr
Gainesville, FL 32608
Phone (352) 335-7777

4910 NW 27th Ct
Gainesville, FL 32606
Phone 3523357777 ext. 2

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1752624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752624000000",
    "number": "1902798903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5209 SW 91ST DR",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326083028",
            "telephone_number": "352-335-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5209 SW 91ST DR",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326083028",
            "telephone_number": "352-335-7777",
            "fax_number": "352-727-4066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4910 NW 27th Ct",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326066590",
            "country_code": "US",
            "telephone_number": "352-335-7777 x2",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KODP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-16",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "JESSICA",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "352-335-7777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "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": "Kid Only Dental Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; 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.