Gregory F Kewitt, MD, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DS029616L Issued in PA

Practice address

474 Windmere Dr
Suite 202
State College, PA 16801-7668

Phone

(814) 235-7700

Fax

(814) 235-7633

NPI assigned

May 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2008 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Centre Oral & Facial Surgery, P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • State College, PA
  • NPI 1386692184

  Oral and Maxillofacial Surgery

  NPD Authorized official

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1154379873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "474 WINDMERE DR STE 202",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017643",
            "telephone_number": "814-235-7700",
            "fax_number": "814-235-7633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "474 WINDMERE DR",
            "address_2": "SUITE 202",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017668",
            "telephone_number": "814-235-7700",
            "fax_number": "814-235-7633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEWITT",
        "first_name": "GREGORY",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD, DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "PA",
            "license": "MD073230L",
            "primary": false
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "PA",
            "license": "MD073230L",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS029616L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Virginia Kenyon, LSW
• John Gordon Kenyon Jr., MS LPC
• Nina Kephart
• Kowo Kesselly
• Kevin P Labosky DMD LLC
• Keys to Communication
• Keystone Care Partners LLC
• Keystone Rehabilitation Systems Inc
• Keystone Service Systems, Inc
• Keystone Service Systems, Inc

• All providers in State College, PA
• Oral and Maxillofacial Surgery (Dentist) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.