NPIMap

Organization Active NPI

Kennedy Dental Office

  • General Practice Dentistry
  • Whitesville, WV
National Provider Identifier
1033270970
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
KENNEDY DENTAL OFFICE
Practice address
38924 Coal River Rd.
Whitesville, WV 25209
Phone
(304) 854-2110
Fax
(304) 854-2111
NPI assigned
Dec 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Kimberly A. Dillon
Title
Account Manager
Phone
(304) 744-9717

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

38924 Coal River Rd.
Whitesville, WV 25209

Mailing address

PO Box 776
Whitesville, WV 25209-0776
Phone (304) 854-2110

National Provider Directory

National Provider Directory
Tax ID family
Kennedy Dental Office3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033270970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776",
            "city": "WHITESVILLE",
            "state": "WV",
            "postal_code": "252090776",
            "telephone_number": "304-854-2110",
            "fax_number": "304-854-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38924 COAL RIVER RD.",
            "city": "WHITESVILLE",
            "state": "WV",
            "postal_code": "25209",
            "telephone_number": "304-854-2110",
            "fax_number": "304-854-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEDY DENTAL OFFICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DILLON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "ACCOUNT MANAGER",
        "authorized_official_telephone_number": "304-744-9717",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitesville, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.