Individual provider Active NPI

Kevin Jay Andrews, D.D.S.,M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Sparks, NV
National Provider Identifier
1023749157
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
345 Issued in NV
Practice address
2125 Green Vista Dr Ste 104
Sparks, NV 89431-8515
Phone
(775) 527-7953
Fax
(775) 674-1515
NPI assigned
Jun 20, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 345 NV Primary

Addresses

Primary practice location

2125 Green Vista Dr Ste 104
Sparks, NV 89431-8515

Mailing address

2125 Green Vista Dr Ste 104
Sparks, NV 89431-8515
Phone (775) 527-7953

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Rutkowski & Fung, DDS, DMD, PLLC Orthodontics and Dentofacial Orthopedics CurrentSince Dec 15, 2024 Accepting new patients
Kevin J Andrews DDS Ms a Professional Corporation Orthodontics and Dentofacial Orthopedics PastSince Jun 26, 2022 Accepting new patients

Locations

2125 Green Vista Dr
Ste 104
Sparks, NV 89431
Phone (775) 527-7953

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1655683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1023749157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2125 GREEN VISTA DR STE 104",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894318515",
            "telephone_number": "775-527-7953",
            "fax_number": "775-674-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2125 GREEN VISTA DR STE 104",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894318515",
            "telephone_number": "775-527-7953",
            "fax_number": "775-674-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREWS",
        "first_name": "KEVIN",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.,M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-20",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NV",
            "license": "345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparks, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.