KIDDIE KINGDUM ACADEMY NPI 1104760990

NPI Information

  • NPI: 1104760990
  • Provider Name: KIDDIE KINGDUM ACADEMY
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • Address: 1400 SCOTT LAKE RD
    WATERFORD, MI
    ZIP 48328
  • Phone: (248) 515-0549

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NPI Details

KIDDIE KINGDUM ACADEMY is a specialist in Waterford, MI. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. KIDDIE KINGDUM ACADEMY NPI is 1104760990. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1400 SCOTT LAKE RD
WATERFORD, MI
ZIP 48328-534
Phone: (248) 515-0549

The provider's authorized official is Sierra Travis .
The authorized official title is Owner and has the following contact phone number (248) 515-0549.

The enumeration date for this NPI number is 4/14/2026 and was last updated on 4/14/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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