Individual provider Active NPI

Todd Candler Kincer, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Lenoir, NC
National Provider Identifier
1154470920
Registry record updated Nov 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
8154 Issued in NC
Practice address
310 Mulberry St SW
Lenoir, NC 28645-5721
Phone
(828) 754-7881
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 8154 NC Primary

Addresses

Primary practice location

310 Mulberry St SW
Lenoir, NC 28645-5721

Mailing address

115 Island Ridge Dr
Statesville, NC 28677-2097
Phone (704) 528-8340

Other identifiers 1

IdentifierTypeStateIssuer
5905741MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8154NCMDMental Health Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Manisha Desai Patel DDS Oral and Maxillofacial Surgery Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353456000000",
    "number": "1154470920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 ISLAND RIDGE DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286772097",
            "telephone_number": "704-528-8340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 MULBERRY ST SW",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286455721",
            "telephone_number": "828-754-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINCER",
        "first_name": "TODD",
        "middle_name": "CANDLER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2012-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NC",
            "license": "8154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5905741",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lenoir, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2012; 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.