John Alexander Kennedy Jr., D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4377 Issued in SC

Practice address

2498 N Pleasantburg Dr
Suite: C
Greenville, SC 29609-2730

Phone

(864) 501-0070

NPI assigned

Dec 24, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1198454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426550400000",
    "number": "1184808396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31625",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296081625",
            "telephone_number": "864-501-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2498 N PLEASANTBURG DR",
            "address_2": "SUITE: C",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296092730",
            "telephone_number": "864-501-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JOHN",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-24",
        "last_updated": "2015-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "4377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Burris Kenna III, DMD
• Alixandra Kennedy
• Bonnie Sue Kennedy, MD
• Brandy Kay Kennedy, ND
• Ellen Kennedy
• Kelly Zornig Kennedy, MSN, FNP-BC
• Marilyn Kennedy, MA-COUNSELING
• Nicholas Lee Kennedy, D.O.
• Byron T Kennerly, MD
• Alyson Cotter Kenneson, LMSW

• General Practice Dentistry in Greenville, SC
• Providers in Greenville, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.