NPIMap

Organization Active NPI

Kennedy Dentistry, P. C.

  • General Practice Dentistry
  • Powell, TN
National Provider Identifier
1083625248
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8101 Issued in TN
Legal business name
KENNEDY DENTISTRY, P. C.
Practice address
2529 W Emory Rd
Powell, TN 37849-3712
Phone
(865) 947-2220
Fax
(865) 947-2223
NPI assigned
Aug 11, 2006
Last updated
Aug 22, 2020By the provider in NPPES
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
Dr. Roger Patrick Kennedy, D.D.S.
Title
Dr./Owner
Phone
(865) 947-2220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8101 TN Primary

Addresses

Primary practice location

2529 W Emory Rd
Powell, TN 37849-3712

Mailing address

2529 W Emory Rd
Powell, TN 37849-3712
Phone (865) 947-2220

National Provider Directory

National Provider Directory

Locations

2529 W Emory Rd
Powell, TN 37849
Phone (865) 947-2220

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083625248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2529 W EMORY RD",
            "city": "POWELL",
            "state": "TN",
            "postal_code": "378493712",
            "telephone_number": "865-947-2220",
            "fax_number": "865-947-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2529 W EMORY RD",
            "city": "POWELL",
            "state": "TN",
            "postal_code": "378493712",
            "telephone_number": "865-947-2220",
            "fax_number": "865-947-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEDY DENTISTRY, P. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "DR./OWNER",
        "authorized_official_telephone_number": "865-947-2220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "8101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Powell, TN

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.