NPIMap

Organization Active NPI

Kevin Chidester, D.M.D., P.L.L.C.

  • Dental Clinic/Center
  • Knightdale, NC
National Provider Identifier
1255168282
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
KEVIN CHIDESTER, D.M.D., P.L.L.C.
Practice address
6807 Knightdale Blvd Ste E&F
Knightdale, NC 27545-6562
Phone
(978) 254-1322
NPI assigned
Sep 16, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Authorized official

Name
Dr. Kevin ChidesterNPI 1992498844
Title
Managing Member
Phone
(978) 254-1322

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
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

6807 Knightdale Blvd Ste E&F
Knightdale, NC 27545-6562

Mailing address

3012 Bethwicke CT
Raleigh, NC 27604-4964

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726444800000",
    "number": "1255168282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3012 BETHWICKE CT",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276044964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6807 KNIGHTDALE BLVD STE E&F",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275456562",
            "telephone_number": "978-254-1322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN CHIDESTER, D.M.D., P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-16",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-15",
        "status": "A",
        "authorized_official_last_name": "CHIDESTER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "978-254-1322",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knightdale, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.