Chris D Kinney, DDS
Individual provider Active NPI Oral and Maxillofacial Surgery (Dentist) · Anderson, IN
NPI 1003978586 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1003978586
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist) 1223S0112X
- License
- 12008702 (IN)
- Practice address
- 3825 Fairview Dr
Anderson, IN 46013 - Phone
- (765) 649-8118
- Fax
- (765) 649-8119
- NPI assigned
- Dec 14, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 1, 2012 through Oct 1, 2026
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12008702 | IN | MD | Oral and Maxillofacial Surgery (Dentist) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| M J Patel DDS P.C. | Oral and Maxillofacial Surgery | Past |
Accepting new patients |
| Chris D. Kinney, D.D.S. P.C. | Oral and Maxillofacial Surgery | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 12008702 | IN | Yes |
Addresses
Primary practice location
3825 Fairview Dr
Anderson, IN 46013
Mailing address
3825 Fairview Dr
Anderson, IN 46013
Phone (765) 649-8118
Other providers in Anderson, IN
- Richard Kyungho Kim
- Desiree King
- Jennifer Lynn King
- Mallory King
- Tanner King
- Kinship Medical Transportation
- Patrick C Kippenbrock
- Stephen E Kirkman
- Hannah Kleyn
- Christina A Kline
All providers in Anderson, IN · Oral and Maxillofacial Surgery (Dentist) in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.