Kenneth V Pineschi, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

019016143 Issued in IL

Practice address

1506 N Rockton Ave
Rockford, IL 61103-4388

Phone

(815) 968-6688

Fax

(815) 968-8989

NPI assigned

Apr 8, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

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)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213574400000",
    "number": "1083887319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 N ROCKTON AVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611034388",
            "telephone_number": "815-968-6688",
            "fax_number": "815-968-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 N ROCKTON AVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611034388",
            "telephone_number": "815-968-6688",
            "fax_number": "815-968-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINESCHI",
        "first_name": "KENNETH",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-08",
        "last_updated": "2008-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019016143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019016143",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassandra Pilcher
• Alexis Amelia Piller
• Paige Elizabeth Piller
• Bailey Pilson, MD
• Maxita M Pinawin, NP
• Nicole Ping Ticknor, LPC
• John Pingo, BCBA
• Leonard Pink, LCSW MSW
• Heather Moon Piper, R.N., M.S., C.N.M.
• Jesseca Pirkle, MD MPH

• Dentist in Rockford, IL
• Providers in Rockford, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.