Kenneth Boyd Lewis, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5029 Issued in NC

Practice address

4140 Ramsey St Ste 104
Fayetteville, NC 28311-7658

Phone

(910) 488-0518

Fax

(910) 630-2432

NPI assigned

Jan 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Lewis, Dine and Associates, P.a.

  • General Practice Dentistry
  • Fayetteville, NC
  • NPI 1336317692
  NPD Authorized official

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1023097870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 RAMSEY ST STE 104",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283117658",
            "telephone_number": "910-488-0518",
            "fax_number": "910-630-2432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 RAMSEY ST STE 104",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283117658",
            "telephone_number": "910-488-0518",
            "fax_number": "910-630-2432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "KENNETH",
        "middle_name": "BOYD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "5029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8995255",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "95255",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "507178",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angelica Lewis
• Carlos M Lewis, D.O.
• Lewis, Dine and Associates, P.a.
• Equilla Rena Lewis, NP
• Jennifer Eileen Lewis, COTA
• Kenneth Boyd Lewis Jr., DMD
• Kenneth Bryant Lewis, D.O.
• Lauryn Kay Lewis, PHARMD
• Makenzie Wise Lewis, LBA
• Miesha Lewis

• General Practice Dentistry in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; 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.