Kenton D Brandimore, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN 22023 Issued in FL

Practice address

9200 113TH St
Seminole, FL 33772-2800

Phone

(727) 394-6064

NPI assigned

Sep 21, 2016

Last updated

Sep 21, 2016By the provider in NPPES

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 FL

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": "1474416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474416000000",
    "number": "1023566841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 113TH ST",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337722800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 113TH ST",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337722800",
            "telephone_number": "727-394-6064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDIMORE",
        "first_name": "KENTON",
        "middle_name": "D",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-21",
        "last_updated": "2016-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 22023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine L. Bourne, M.S.W.
• Alexis Marie Bowling, LMHC
• Harold A Bradfield, M. D.
• Ruth E. Bradley, D.C.
• Caitlin J Brady, RPH
• Brandi Lynn Branton
• Adam J Bressler, DDS
• Erin Brewbaker
• Jessica Renee Brewer, DMD
• Bridges Medical Supplies Inc

• Dentist in Seminole, FL
• Providers in Seminole, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; 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.