Individual provider Active NPI

Nicholas Matthew Kerns, D.D.S.

  • Pediatric Dentistry
  • Columbus, OH
National Provider Identifier
1174820468
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
30.023881 Issued in OH
Practice address
5180 E Main St Ste C
Columbus, OH 43213-2436
Phone
(614) 868-0718
NPI assigned
Feb 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.023881 OH
Pediatric Dentistry 1223P0221X 30.023881 OH Primary

Addresses

Primary practice location

5180 E Main St Ste C
Columbus, OH 43213-2436

Mailing address

5180 E Main St Ste C
Columbus, OH 43213-2436
Phone (614) 868-0718

Other practice location 1

700 Childrens Dr
Columbus, OH 43205-2664
Phone (614) 722-2000

Other practice location 2

380 Butterfly Gardens Dr
Columbus, OH 43215-7508
Phone (614) 722-5650

Other identifiers 1

IdentifierTypeStateIssuer
0080530MedicaidOH

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
30.023881OHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Nicholas M Kerns DDS LLC Pediatric Dentistry Current Accepting new patients
Nicholas M. Kerns, DDS, Ms, LLC Pediatric Dentistry Current Accepting new patients
Ocean Dental of Ohio, P.C. Past Accepting new patients
Musial-Gill Properties LLC PastSince Sep 13, 2020 Accepting new patients

Locations

1021 Country Club Rd
Unit B
Columbus, OH 43213
Phone (614) 762-7312

5180 E Main St
Ste C
Columbus, OH 43213
Phone (614) 868-0718

Organizations & group practices 4

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": "1298332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1174820468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5180 E MAIN ST STE C",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432132436",
            "telephone_number": "614-868-0718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5180 E MAIN ST STE C",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432132436",
            "telephone_number": "614-868-0718"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Childrens Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432052664",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "380 Butterfly Gardens Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432157508",
            "country_code": "US",
            "telephone_number": "614-722-5650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KERNS",
        "first_name": "NICHOLAS",
        "middle_name": "MATTHEW",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-22",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.023881",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "30.023881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0080530",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; 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.