Active NPI
Kevin Lee Lovell, DDS
- Dentist
- Wausau, WI
National Provider Identifier
1225106958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2617
- Practice address
- 3319 Terrace CT
Wausau, WI 54401 - Phone
- (715) 842-4880
- NPI assigned
- Dec 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2617 | WI | Primary |
Addresses
Primary practice location
3319 Terrace CT
Wausau, WI 54401
Mailing address
3319 Terrace CT
Wausau, WI 54401
Phone (715) 842-4880
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33424400 | Other | WI | TITLE 19 MEDICAL ASSISTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1225106958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3319 TERRACE CT",
"city": "WAUSAU",
"state": "WI",
"postal_code": "54401",
"telephone_number": "715-842-4880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3319 TERRACE CT",
"city": "WAUSAU",
"state": "WI",
"postal_code": "54401",
"telephone_number": "715-842-4880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOVELL",
"first_name": "KEVIN",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "2617",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TITLE 19 MEDICAL ASSISTAN",
"identifier": "33424400",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wausau, WI
Sources for this page
- 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.