Jared Kenney, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D009960 Issued in AZ

Practice address

21300 N John Wayne Pkwy Ste 114
Maricopa, AZ 85139

Phone

(520) 231-6700

Fax

(520) 208-9066

NPI assigned

May 30, 2014

Sex

Male

Sole proprietor

No

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 AZ

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

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.

• Oasis Oral and Facial Surgery PLLC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Maricopa, AZ
  • NPI 1023593068
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1401408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735344000000",
    "number": "1104238716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3232 E REDWOOD LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487834",
            "telephone_number": "916-204-8762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21300 N JOHN WAYNE PKWY STE 114",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "85139",
            "telephone_number": "520-231-6700",
            "fax_number": "520-208-9066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3200 S Gilbert Rd Ste 117",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852865107",
            "country_code": "US",
            "telephone_number": "520-231-6700",
            "fax_number": "520-208-9066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEY",
        "first_name": "JARED",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-30",
        "last_updated": "2024-12-28",
        "certification_date": "2024-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AZ",
            "license": "D009960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronny Kassees
• Matthew Alan Kaul, PTA
• Monique S Kaur-Dale, BSN, RN
• Mawa Keita
• Jonathan Andrew Keller, D.M.D.
• Christina Kern
• Kiddes Crowned Care LLC
• Kidz Rule Inc
• Karen King, FNP
• Nicole Kissmann, OTD, OTR/L

• Oral and Maxillofacial Surgery (Dentist) in Maricopa, AZ
• Providers in Maricopa, AZ by specialty
• Oral and Maxillofacial Surgery (Dentist) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2024; 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.