West Kerr Dental, Professional Limited Liability C

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

WEST KERR DENTAL, PROFESSIONAL LIMITED LIABILITY C

Doing business as

none

Practice address

3164 Junction Hwy Ste W-1
Ingram, TX 78025-3194

Phone

(830) 367-1171

NPI assigned

Jan 18, 2023

Last updated

May 22, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Susannah M C Mitchell, DMD

Title

Owner

Phone

(303) 671-1718

Specialties & licenses 2

Addresses

Other names 1

• none Doing business as

Electronic endpoints 1

Locations

Practitioners 1

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.

• Susannah Martha Mitchell, DMD

  • General Practice Dentistry
  • Ingram, TX
  • NPI 1699042655
  NPD

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

{
    "created_epoch": "1674000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716336000000",
    "number": "1952016503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3164 JUNCTION HWY STE W-1",
            "city": "INGRAM",
            "state": "TX",
            "postal_code": "780253194",
            "telephone_number": "830-367-1171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3164 JUNCTION HWY STE W-1",
            "city": "INGRAM",
            "state": "TX",
            "postal_code": "780253194",
            "telephone_number": "830-367-1171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST KERR DENTAL, PROFESSIONAL LIMITED LIABILITY C",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-18",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "SUSANNAH M",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-671-1718",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "westkerdental.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3164 Junction Hwy Ste W-1",
            "city": "Ingram",
            "state": "TX",
            "country_code": "US",
            "postal_code": "780253194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "none",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "none",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael L Ray, DDS
• Recovery Medicine, PLLC
• Kathleen Saunders Vlasek
• Therapeia Counseling Center, PLLC
• Justin Joaquin Vigil, M.D.
• Shauna Ann Wickham, LPC
• Thomas W. Wickham, L.P.C.
• Lance Wayne Wilke, ATC, LAT, CSCS, PES

• General Practice Dentistry in Ingram, TX
• Providers in Ingram, 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 May 22, 2024; 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.