Jennifer A Kennedy, DDS

Primary specialty

DentistTaxonomy code 122300000X

Practice address

601 Broadway Ave
Mattoon, IL 61938-4340

Phone

(217) 235-0556

NPI assigned

Jul 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jennifer a Kennedy DDS LLC

  • Dental Clinic/Center
  • Mattoon, IL
  • NPI 1992136345
  NPD (past) Authorized official
• Philip B. Kepp, DDS,PC

  • General Practice Dentistry
  • Mattoon, IL
  • NPI 1275569923
  NPD (past)

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": "1013936962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2544 NORTH COUNTY ROAD 1800 EAST",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "61920",
            "telephone_number": "217-345-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 BROADWAY AVE",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384340",
            "telephone_number": "217-235-0556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janean Marie Karpus
• Constantine Dean Katsamakis, DO
• Tory L. Keefer, FNP
• Lana Keigley
• David M. Kellerhals, B.A.
• Nazer Keong, PT
• Philip B. Kepp, DDS
• Olivia Keske
• Kevin Elliott Counseling, PC
• Nafees Khan, MD

• Dentist in Mattoon, IL
• Providers in Mattoon, IL by specialty
• Dentist in Illinois

• 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.