Kenneth W. Nelson, DDS, PA

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

5149 Issued in KS

Legal business name

KENNETH W. NELSON, DDS, PA

Practice address

1919 N. Webb Rd
Wichita, KS 67206-3405

Phone

(316) 634-1414

Fax

(316) 634-2907

NPI assigned

Jul 21, 2010

Organization subpart

No

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

Authorized official

Name

Kenneth W Nelson, DDS

Title

Owner

Phone

(316) 634-1414

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1279670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279670400000",
    "number": "1013220813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 N WEBB RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063405",
            "telephone_number": "316-634-1414",
            "fax_number": "316-634-2907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 N. WEBB RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063405",
            "telephone_number": "316-634-1414",
            "fax_number": "316-634-2907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH W. NELSON, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-21",
        "last_updated": "2010-07-21",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "316-634-1414",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "KS",
            "license": "5149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelli Dawn Kennedy, LSCSW
• Marcia Kennedy, LCP, LSCSW
• Mark Kennedy, ATC
• Susan Lynn Kennedy, M.S. CCC-SLP
• Joshua Michael Kennell
• Janet C Kenny, SLP
• Aaron David Kent, RN
• Aggrey K Keny, MD
• Carey D Kenyon, MA
• Kristin Danielle Kenyon, APRN

• Oral and Maxillofacial Surgery (Dentist) in Wichita, KS
• Providers in Wichita, KS by specialty
• Oral and Maxillofacial Surgery (Dentist) in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2010; 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.