Individual provider Active NPI

Kevin Kennedy, DMD

  • General Practice Dentistry
  • Hyannis, MA
National Provider Identifier
1205865664
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14208 Issued in MA
Practice address
30 Elm Ave
Hyannis, MA 02601-5547
Phone
(508) 778-0300
Fax
(508) 778-8747
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 14208 MA Primary

Addresses

Primary practice location

30 Elm Ave
Hyannis, MA 02601-5547

Mailing address

2 Center Hill Rd
Kingston, MA 02364-1508
Phone (781) 585-6680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20160706002433 MA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1557653847

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14208MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Health Services, Inc. Past Accepting new patients
Harbor Health Services, Inc Past Accepting new patients
Harbor Health Services Past Accepting new patients

Organizations & group practices 3

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205865664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CENTER HILL RD",
            "city": "KINGSTON",
            "state": "MA",
            "postal_code": "023641508",
            "telephone_number": "781-585-6680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 ELM AVE",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026015547",
            "telephone_number": "508-778-0300",
            "fax_number": "508-778-8747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "KEVIN",
        "name_prefix": "Mr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "14208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyannis, MA

Sources for this page

Verify at the official NPI Registry.