John David Kenney, MD DDS

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

MD0022210 Issued in WA

Practice address

7345 Linderson Way SW
Tumwater, WA 98501-6504

Phone

(360) 725-8713

Fax

(360) 586-9060

NPI assigned

Mar 21, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358121600000",
    "number": "1114043288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41123",
            "address_2": "MS 41123",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985041123",
            "telephone_number": "360-725-8713",
            "fax_number": "360-586-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7345 LINDERSON WAY SW",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985016504",
            "telephone_number": "360-725-8713",
            "fax_number": "360-586-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEY",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD  DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2013-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WA",
            "license": "MD0022210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Tumwater, WA
• Providers in Tumwater, WA by specialty
• General Practice Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2013; 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.