Active NPI
Kenneth Charles Stanifer, DDS
- General Practice Dentistry
- Morristown, TN
National Provider Identifier
1174619258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DS5190
- Practice address
- 233 King Ave
Morristown, TN 37814-6642 - Phone
- (423) 586-1242
- Fax
- (423) 586-1484
- NPI assigned
- Oct 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS5190 | TN | Primary |
Addresses
Primary practice location
233 King Ave
Morristown, TN 37814-6642
Mailing address
233 King Ave
Morristown, TN 37814-6642
Phone (423) 586-1242
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
| License | State | Type | Specialty |
|---|---|---|---|
| DS5190 | TN | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174619258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "233 KING AVE",
"city": "MORRISTOWN",
"state": "TN",
"postal_code": "378146642",
"telephone_number": "423-586-1242",
"fax_number": "423-586-1484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "233 KING AVE",
"city": "MORRISTOWN",
"state": "TN",
"postal_code": "378146642",
"telephone_number": "423-586-1242",
"fax_number": "423-586-1484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STANIFER",
"first_name": "KENNETH",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TN",
"license": "DS5190",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Morristown, TN
- Southern Home Care Services, Inc. (All Ways Caring HomeCare)
- Southern Home Care Services, Inc. (All Ways Caring HomeCare)
- Southern Orthocare Inc
- Shamron Stambaugh, NE
- Samantha Grace Stanfill
- Julianne Stapleton, RNC MSN
- Georganna J Starnes, MD
- State of Tennessee (Hamblen County Health Department)
- James Stephen Stelzman, D.D.S.
- James Stergios III, PHARM.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.