Individual provider Active NPI

Joseph Maughan Kent, D.D.S.

  • Dentist
  • Lake Isabella, CA
National Provider Identifier
1023010840
Registry record updated Oct 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
25919 Issued in CA
Practice address
6421 Lynch Canyon Dr
Lake Isabella, CA 93240-9726
Phone
(760) 379-3626
NPI assigned
Aug 11, 2005
Last updated
Oct 16, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 25919 CA Primary

Addresses

Primary practice location

6421 Lynch Canyon Dr
Lake Isabella, CA 93240-9726

Mailing address

PO Box 186
Lake Isabella, CA 93240-0186
Phone (760) 379-3625

Other identifiers 1

IdentifierTypeStateIssuer
B25919OtherCADENTI-CAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160518001848 CA Order and Referring Only - DentistPractitioner - Dentist 7416246244

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25919CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph M Kent DDS Inc. Dentist PastSince Nov 10, 2019 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381881600000",
    "number": "1023010840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 186",
            "city": "LAKE ISABELLA",
            "state": "CA",
            "postal_code": "932400186",
            "telephone_number": "760-379-3625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6421 LYNCH CANYON DR",
            "city": "LAKE ISABELLA",
            "state": "CA",
            "postal_code": "932409726",
            "telephone_number": "760-379-3626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENT",
        "first_name": "JOSEPH",
        "middle_name": "MAUGHAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2013-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "25919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "B25919",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Isabella, CA

Sources for this page

Verify at the official NPI Registry.