Kennebec Valley Family Dentistry

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

3095 Issued in ME

Legal business name

KENNEBEC VALLEY FAMILY DENTISTRY

Practice address

269 Water St
Augusta, ME 04330-4645

Phone

(207) 623-3400

Fax

(207) 623-3440

NPI assigned

Jun 8, 2009

Last updated

Nov 20, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Kimberley Gordon

Title

Executive Director

Phone

(207) 623-3400

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Audra A Boynton, DMD

  • Dentist
  • Augusta, ME
  • NPI 1609019884
  NPD (past)
• Raymond Scott Cunningham, DDS

  • General Practice Dentistry
  • Augusta, ME
  • NPI 1306108295
  NPD (past)

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

{
    "created_epoch": "1244419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574208000000",
    "number": "1114153939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 E CHESTNUT ST STE 420",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305743",
            "telephone_number": "207-623-3400",
            "fax_number": "207-623-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 WATER ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043304645",
            "telephone_number": "207-623-3400",
            "fax_number": "207-623-3440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEBEC VALLEY FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-08",
        "last_updated": "2019-11-20",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "KIMBERLEY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "207-623-3400",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "ME",
            "license": "3095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kennebec Pharmacy and Home Care LLC (Kennebec Senior Care)
• Kennebec Pharmacy and Home Care LLC
• Kennebec Pharmacy and Home Care LLC (Kennebec Pharmacy & Home Care)
• Kennebec Speech Therapy PLLC
• Kennebec Valley Chiropractic
• Kennebec Valley Obstetrics & Gynecology
• Kennebec Valley Radiology Professional Association
• Rosemarie Kenney-Lavin, F.N.P.
• Ellen J Kenney, RPH, PHARM.D.
• Shannon Kenney, DO

• Point of Service in Augusta, ME
• Providers in Augusta, ME by specialty
• Point of Service in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.