KMC Dental, P.a.

Primary specialty

DentistTaxonomy code 122300000X

License

DEN3619 Issued in ME

Legal business name

KMC DENTAL, P.A.

Practice address

1065 Lisbon St
Lewiston, ME 04240-5749

Phone

(207) 376-4977

Fax

(207) 376-4979

NPI assigned

Jun 29, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Kevin Michael Connelly, DMD

Title

Owner

Phone

(207) 376-4977

Specialties & licenses 1

Addresses

Other names 1

• KMC Dental Former legal business name

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

{
    "created_epoch": "1498694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1225559289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 LISBON STREET",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "04240",
            "telephone_number": "207-376-4977",
            "fax_number": "207-376-4979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1065 LISBON ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042405749",
            "telephone_number": "207-376-4977",
            "fax_number": "207-376-4979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KMC DENTAL, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-29",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CONNELLY",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-376-4977",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "ME",
            "license": "DEN3619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KMC Dental",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Paula Claire Kirby-Long, M.D.
• Savannah C. Kirchner, LCSW
• Edward Bruce Kirn, OD
• Rudi Noelle Klarmann, AUD
• Courtney Caroe Klausen, PT, DPT
• KMR Counseling, Inc
• Casey-Lyn Iris Knight, LMSW-CC
• Darcy-Lynn Suzanne Knight, RDH
• Nicholas Knowland
• John Knowles

• Dentist in Lewiston, ME
• Providers in Lewiston, ME by specialty
• Dentist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.