Organization Active NPI

Kirsten William-Kennedy DDS, Ms, P.C.

  • Dentist
  • Rapid City, SD
National Provider Identifier
1073063830
Registry record updated Apr 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
M721 Issued in SD
Legal business name
KIRSTEN WILLIAM-KENNEDY DDS, MS, P.C.
Practice address
740 Sheridan LK. Rd. Suite a
Rapid City, SD 57702
Phone
(605) 341-0826
Fax
(605) 341-1153
NPI assigned
Oct 5, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2019

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

Authorized official

Name
Kirsten William-Kennedy, DDS, MS
Title
Owner/President
Phone
(605) 341-0826

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X M721 SD Primary

Addresses

Primary practice location

740 Sheridan LK. Rd. Suite a
Rapid City, SD 57702

Mailing address

740 Sheridan LK. Rd. Suite a
Rapid City, SD 57702
Phone (605) 341-0826

Other names 1

  • Dedicated Dental Solutions Doing business as

National Provider Directory

National Provider Directory

Locations

740 Sheridan Lake Rd
Ste A
Rapid City, SD 57702
Phone (605) 341-0826

Practitioners & affiliated clinicians

Practitioners 1

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": "1475625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556064000000",
    "number": "1073063830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 SHERIDAN LK. RD. SUITE A",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "57702",
            "telephone_number": "605-341-0826",
            "fax_number": "605-341-1153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 SHERIDAN LK. RD. SUITE A",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "57702",
            "telephone_number": "605-341-0826",
            "fax_number": "605-341-1153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIRSTEN WILLIAM-KENNEDY DDS, MS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-05",
        "last_updated": "2019-04-24",
        "status": "A",
        "authorized_official_last_name": "WILLIAM-KENNEDY",
        "authorized_official_first_name": "KIRSTEN",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "605-341-0826",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "SD",
            "license": "M721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dedicated Dental Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rapid City, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; 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.