Individual provider Active NPI

Kayla Ashley Jang, DMD

  • Pediatric Dentistry
  • Aubrey, TX
National Provider Identifier
1972170405
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
39453 Issued in TX
Practice address
27045 E University Dr Ste 2a
Aubrey, TX 76227-2746
Phone
(469) 277-1787
NPI assigned
Jun 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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 019.033262 IL
Pediatric Dentistry 1223P0221X 39453 TX Primary

Addresses

Primary practice location

27045 E University Dr Ste 2a
Aubrey, TX 76227-2746

Mailing address

5001 Newport Dr
Rolling Meadows, IL 60008-3801
Phone (224) 636-2223

Other practice location 1

5001 Newport Dr
Rolling Meadows, IL 60008-3801
Phone (224) 636-2223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019.033262ILMDGeneral Practice Dentistry
39453TXMDLicensed Vocational Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Windhaven Pediatric Dentistry PLLC Pediatric Dentistry CurrentSince Feb 4, 2024 Accepting new patients

Locations

27045 E University Dr
Ste 2A
Little Elm, TX 76227
Phone (469) 277-1787

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": "1622764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1972170405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 NEWPORT DR",
            "city": "ROLLING MEADOWS",
            "state": "IL",
            "postal_code": "600083801",
            "telephone_number": "224-636-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27045 E UNIVERSITY DR STE 2A",
            "city": "AUBREY",
            "state": "TX",
            "postal_code": "762272746",
            "telephone_number": "469-277-1787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5001 Newport Dr",
            "address_purpose": "LOCATION",
            "city": "Rolling Meadows",
            "state": "IL",
            "postal_code": "600083801",
            "country_code": "US",
            "telephone_number": "224-636-2223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JANG",
        "first_name": "KAYLA",
        "middle_name": "ASHLEY",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-04",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.033262",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "39453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aubrey, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.