Individual provider Active NPI

Kenneth George Chen, D.D.S.

  • General Practice Dentistry
  • Apopka, FL
National Provider Identifier
1205027968
Registry record updated Feb 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN20768 Issued in FL
Practice address
225 Copper Oak CT
Apopka, FL 32703-1316
Phone
(760) 845-6334
NPI assigned
Aug 7, 2007
Last updated
Feb 9, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 54522 CA
General Practice Dentistry 1223G0001X DN20768 FL Primary

Addresses

Primary practice location

225 Copper Oak CT
Apopka, FL 32703-1316

Mailing address

225 Copper Oak CT
Apopka, FL 32703-1316
Phone (760) 845-6334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20160223001792 FL Order and Referring Only - DentistPractitioner - Dentist 0941505358

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
54522CAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423440000000",
    "number": "1205027968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 COPPER OAK CT",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327031316",
            "telephone_number": "760-845-6334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 COPPER OAK CT",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327031316",
            "telephone_number": "760-845-6334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "KENNETH",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-07",
        "last_updated": "2015-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54522",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN20768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apopka, FL

Sources for this page

Verify at the official NPI Registry.