Gabriel M Kennedy, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D8916 Issued in OR

Practice address

1040 24TH Ave SW
Albany, OR 97321-7539

Phone

(541) 924-9000

Fax

(541) 926-1036

NPI assigned

Mar 26, 2008

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

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277251200000",
    "number": "1023280344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 24TH AVE SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973217539",
            "telephone_number": "541-924-9000",
            "fax_number": "541-926-1036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 24TH AVE SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973217539",
            "telephone_number": "541-924-9000",
            "fax_number": "541-926-1036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "GABRIEL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-26",
        "last_updated": "2010-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OR",
            "license": "D8916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yvonne Elaine Keep, FNP-BC
• Norma Kehdi Kehdi
• Michael B Kelty
• Jessica Kempken
• Abigail Townsend Kennedy, M.D.
• Courtney Joy Kennison, CPNP-PC
• Ronald Kerlee
• Kevin C Kern
• Eric William Kerstetter, DPT
• Suzanne Kesterson, M.A., CCC-SLP

• Oral and Maxillofacial Surgery (Dentist) in Albany, OR
• Providers in Albany, OR by specialty
• Oral and Maxillofacial Surgery (Dentist) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.