Provider Demographics
NPI:1730368739
Name:HILDEBRAND, KIMBERLY JACKSON (DDS)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:JACKSON
Last Name:HILDEBRAND
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5321 EAST MOCKINGBIRD LANE
Mailing Address - Street 2:STE. NO 210
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206
Mailing Address - Country:US
Mailing Address - Phone:214-824-7873
Mailing Address - Fax:214-824-7873
Practice Address - Street 1:5321 EAST MOCKINGBIRD LANE
Practice Address - Street 2:STE. 210
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206
Practice Address - Country:US
Practice Address - Phone:214-824-7873
Practice Address - Fax:214-824-7873
Is Sole Proprietor?:No
Enumeration Date:2007-10-26
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22712122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist