Individual provider Active NPI

Kevin L Klinedinst, D.D.S.

  • General Practice Dentistry
  • Madison, IN
National Provider Identifier
1003835992
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8645 Issued in IN
Practice address
110 Miles Ridge Rd
Madison, IN 47250-2410
Phone
(812) 273-4524
Fax
(812) 273-5745
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8645 IN Primary

Addresses

Primary practice location

110 Miles Ridge Rd
Madison, IN 47250-2410

Mailing address

110 Miles Ridge Rd
Madison, IN 47250-2410
Phone (812) 273-4524

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
8645INMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003835992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 MILES RIDGE RD",
            "city": "MADISON",
            "state": "IN",
            "postal_code": "472502410",
            "telephone_number": "812-273-4524",
            "fax_number": "812-273-5745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MILES RIDGE RD",
            "city": "MADISON",
            "state": "IN",
            "postal_code": "472502410",
            "telephone_number": "812-273-4524",
            "fax_number": "812-273-5745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINEDINST",
        "first_name": "KEVIN",
        "middle_name": "L",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "8645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.