NPIMap

Organization Active NPI

Chanda a. Kennemer, DDS, PC

  • Pediatric Dentistry
  • Stillwater, OK
National Provider Identifier
1194900555
Registry record updated Jan 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
79 Issued in OK
Legal business name
CHANDA A. KENNEMER, DDS, PC
Practice address
1405 S Sangre Rd
Stillwater, OK 74074-1832
Phone
(405) 533-1233
NPI assigned
Jan 4, 2008
Last updated
Jan 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2008

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

Authorized official

Name
Chanda Ann Kennemer, DDSNPI 1477766475
Title
Pediatric Dentist
Phone
(405) 533-1233

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 79 OK Primary

Addresses

Primary practice location

1405 S Sangre Rd
Stillwater, OK 74074-1832

Mailing address

1405 S Sangre Rd
Stillwater, OK 74074-1832
Phone (405) 533-1233

National Provider Directory

National Provider Directory

Locations

1405 S Sangre Rd
Stillwater, OK 74074
Phone (405) 533-1233

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1199404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199404800000",
    "number": "1194900555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 S SANGRE RD",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740741832",
            "telephone_number": "405-533-1233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 S SANGRE RD",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740741832",
            "telephone_number": "405-533-1233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANDA A. KENNEMER, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-04",
        "last_updated": "2008-01-04",
        "status": "A",
        "authorized_official_last_name": "KENNEMER",
        "authorized_official_first_name": "CHANDA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "405-533-1233",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OK",
            "license": "79",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2008; 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.