Kevin L Lewis, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS007408 Issued in TN

Practice address

3900 Bristol Hwy # B-14
Johnson City, TN 37601-1378

Phone

(423) 282-1842

NPI assigned

Dec 29, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184780603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 BRISTOL HWY # B-14",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011378",
            "telephone_number": "423-282-1842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 BRISTOL HWY # B-14",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011378",
            "telephone_number": "423-282-1842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "KEVIN",
        "middle_name": "L",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS007408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4004301",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "451884",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brett Lewis
• Darlene Marie Lewis, LPN
• James Vincent Lewis, M.D.
• Jeanne Lynne Lewis, MD
• Kelley Grace Lewis
• Lori K. Lewis, D.PH.
• Samuel V Lewis, M.D.
• Sarai Nicole Lewis, MSW
• John Bradford Lichlyter, MSN, APRN, NP-C, CEN
• Life Well Cadence Laboratories LLC

• General Practice Dentistry in Johnson City, TN
• Providers in Johnson City, TN by specialty
• General Practice Dentistry in Tennessee

• 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.

Verify at the official NPI Registry.