NPIMap

Organization Active NPI

Kian Nikdel DDS MSD PLLC

Doing business as Lake Jackson Root Canal Specialists

  • Endodontics
  • Lake Jackson, TX
National Provider Identifier
1942721535
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
32482 Issued in TX
Legal business name
KIAN NIKDEL DDS MSD PLLC
Doing business as
Lake Jackson Root canal Specialists
Practice address
115 N Dixie Dr Ste 200
Lake Jackson, TX 77566-5958
Phone
(979) 236-4222
NPI assigned
Jul 4, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Kian Nikdel, DDS MSDNPI 1366992471
Title
Managing Director
Phone
(832) 762-5072

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
Endodontics 1223E0200X 32482 TX Primary

Addresses

Primary practice location

115 N Dixie Dr Ste 200
Lake Jackson, TX 77566-5958

Mailing address

115 N Dixie Dr Ste 200
Lake Jackson, TX 77566-5958
Phone (979) 297-0633

Other names 1

  • Lake Jackson Root canal Specialists Doing business as

National Provider Directory

National Provider Directory

Locations

115 N Dixie Dr
Ste 200
Lake Jackson, TX 77566
Phone (979) 236-4222

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1499126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1942721535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 N DIXIE DR STE 200",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665958",
            "telephone_number": "979-297-0633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 N DIXIE DR STE 200",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665958",
            "telephone_number": "979-236-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIAN NIKDEL DDS MSD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-04",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "NIKDEL",
        "authorized_official_first_name": "KIAN",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "832-762-5072",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS MSD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "32482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Jackson Root Canal Specialists",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lake Jackson Root canal Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Jackson, TX

Sources for this page

  • 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.