Renee M Kinney, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D12789 Issued in MN

Practice address

1000 Radio Dr
Suite 240
Woodbury, MN 55125-8409

Phone

(651) 739-1894

NPI assigned

Apr 19, 2010

Sex

Female

Sole proprietor

Yes

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 MN

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

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.

• Gillette Children'S Specialty Healthcare

  • Multi-Specialty Clinic/Center
  • St. Paul, MN
  • NPI 1225119175
  Medicare reassignment NPD
• Art & Science Family Dentistry, PA

  • General Practice Dentistry
  • Woodbury, MN
  • NPI 1790922854
  NPD (past) Authorized official
• Gillette Children'S Specialty Healthcare

  • Multi-Specialty Clinic/Center
  • Saint Cloud, MN
  • NPI 1982090528
  NPD
• Gillette Children'S Specialty Healthcare

  • Multi-Specialty Clinic/Center
  • Minnetonka, MN
  • NPI 1598824880
  NPD (past)

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

{
    "created_epoch": "1271635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318896000000",
    "number": "1063738847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 RADIO DR",
            "address_2": "SUITE 240",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551258409",
            "telephone_number": "651-739-1894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 RADIO DR",
            "address_2": "SUITE 240",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551258409",
            "telephone_number": "651-739-1894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNEY",
        "first_name": "RENEE",
        "middle_name": "M",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-19",
        "last_updated": "2011-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D12789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Lyle King, PT, DPT, MSC
• Sierra King
• Georgie L Kinlaw
• Christina M Kinney, OD
• George J Kinney, Jr., D.D.S.
• Andrea May Kirchner
• Jamie K Kirchoff, AU.D., CCC-A
• Kirk M Nelson DC LLC
• Allison Kirk, MSW, LICSW
• Nicole E Kirkpatrick

• Dentist in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; 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.