Active NPI
Kyle D Jepsen, DMD
- General Practice Dentistry
- Dallas, TX
National Provider Identifier
1972624880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 22833
- Practice address
- 208 N Market St
322
Dallas, TX 75202-3206 - Phone
- (214) 757-4500
- Fax
- (214) 757-4501
- NPI assigned
- Apr 2, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 22833 | TX | |
| General Practice Dentistry | 1223G0001X | 13569 | NC | |
| General Practice Dentistry | 1223G0001X | DEN.00205860 | CO | |
| General Practice Dentistry | 1223G0001X | 22833 | TX | Primary |
Addresses
Primary practice location
208 N Market St
322
Dallas, TX 75202-3206
Mailing address
13525 Sprucewood Dr
Dallas, TX 75240-3630
Phone (214) 629-6153
Other practice location 1
680 Mitchell Way
Erie, CO 80516-5450
Phone (729) 274-3635
Other practice location 2
582 Kannapolis Pkwy
Kannapolis, NC 28027
Phone (704) 273-5020
Other identifiers 18
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1479404-04 | Medicaid | TX | |
| 1479404-06 | Medicaid | TX | |
| 1804783-05 | Medicaid | TX | |
| 1479404-01 | Medicaid | TX | |
| 1479404-03 | Medicaid | TX | |
| 1479404-09 | Medicaid | TX | |
| 1479404-11 | Medicaid | TX | |
| 1804783-02 | Medicaid | TX | |
| 1479404-07 | Medicaid | TX | |
| 1479404-10 | Medicaid | TX | |
| 1479404-12 | Medicaid | TX | |
| 1804783-03 | Medicaid | TX | |
| 1804783-04 | Medicaid | TX | |
| 1804783-06 | Medicaid | TX | |
| 1479404-08 | Medicaid | TX | |
| 1804783-07 | Medicaid | TX | |
| 1479404-05 | Medicaid | TX | |
| 1804783-01 | Medicaid | TX |
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
| License | State | Type | Specialty |
|---|---|---|---|
| DEN.00205860 | CO | MD | General Practice Dentistry |
| 22833 | TX | MD | General Practice Dentistry |
| 13569 | NC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alles DDS Kannapolis PLLC | Dentist | Past | 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.
-
- Dentist
- Kannapolis, NC
- NPI 1467152496
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707091200000",
"number": "1972624880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13525 SPRUCEWOOD DR",
"city": "DALLAS",
"state": "TX",
"postal_code": "752403630",
"telephone_number": "214-629-6153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "208 N MARKET ST",
"address_2": "322",
"city": "DALLAS",
"state": "TX",
"postal_code": "752023206",
"telephone_number": "214-757-4500",
"fax_number": "214-757-4501"
}
],
"practiceLocations": [
{
"address_1": "680 Mitchell Way",
"address_purpose": "LOCATION",
"city": "Erie",
"state": "CO",
"postal_code": "805165450",
"country_code": "US",
"telephone_number": "729-274-3635",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "582 Kannapolis Pkwy",
"address_purpose": "LOCATION",
"city": "Kannapolis",
"state": "NC",
"postal_code": "28027",
"country_code": "US",
"telephone_number": "704-273-5020",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JEPSEN",
"first_name": "KYLE",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-02",
"last_updated": "2024-02-05",
"certification_date": "2024-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "22833",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "13569",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CO",
"license": "DEN.00205860",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "22833",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1479404-04",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1479404-06",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1804783-05",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1479404-01",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1479404-03",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1479404-09",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1479404-11",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1804783-02",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1479404-07",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1479404-10",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1479404-12",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1804783-03",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1804783-04",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1804783-06",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1479404-08",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1804783-07",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1479404-05",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1804783-01",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.