Active NPI
Kevin Driscoll, DDS
- Endodontics
- Sanford, NC
National Provider Identifier
1013552579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 13182
- Practice address
- 709 Wicker St Ste a
Sanford, NC 27330-4168 - Phone
- (718) 689-0169
- NPI assigned
- Nov 8, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12633 | CT | |
| Endodontics | 1223E0200X | 13182 | NC | Primary |
Addresses
Primary practice location
709 Wicker St Ste a
Sanford, NC 27330-4168
Mailing address
14 Allen CT
Staten Island, NY 10310-2703
Other practice location 1
630 East St Ste 4
Pittsboro, NC 27312-9475
Phone (718) 689-0169
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12633 | CT | MD | Dentist |
| 13182 | NC | MD | Endodontist |
Interoperability endpoints
- kdriscoll1024916@direct.unc.nchie.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779926400000",
"number": "1013552579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 ALLEN CT",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103102703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "709 WICKER ST STE A",
"city": "SANFORD",
"state": "NC",
"postal_code": "273304168",
"telephone_number": "718-689-0169"
}
],
"practiceLocations": [
{
"address_1": "630 East St Ste 4",
"address_purpose": "LOCATION",
"city": "Pittsboro",
"state": "NC",
"postal_code": "273129475",
"country_code": "US",
"telephone_number": "718-689-0169",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DRISCOLL",
"first_name": "KEVIN",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-11-08",
"last_updated": "2026-05-28",
"certification_date": "2026-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CT",
"license": "12633",
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "NC",
"license": "13182",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sanford, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.