Kevin G Kempers, DDS, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D-3407 Issued in ID

Practice address

3003 W Main St Ste 130
Boise, ID 83702-2026

Phone

(208) 342-7610

Fax

(208) 344-1799

NPI assigned

Sep 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 17, 2015 through Jul 17, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Whitewater Oral Surgery Group PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Boise, ID
  • NPI 1104248053

  Oral and Maxillofacial Surgery

  NPD Authorized official
• Boise Oral and Maxillofacial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Boise, ID
  • NPI 1699949750

  Oral and Maxillofacial Surgery

  NPD (past) Authorized official

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1255435459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 W MAIN ST STE 130",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837022026",
            "telephone_number": "208-342-7610",
            "fax_number": "208-344-1799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 W MAIN ST STE 130",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837022026",
            "telephone_number": "208-342-7610",
            "fax_number": "208-344-1799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMPERS",
        "first_name": "KEVIN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "ID",
            "license": "D-3407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805496900",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805511300",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Kelzer, LCSW
• Angela Kemmsies, LPC
• Jason A Kemp, MD
• Ryan S Kemp, D.P.M.
• Travis Jay Kemp, MD
• Luke Kempers
• Debra Kempker
• Ken Wells Counseling
• Taylor Jo Kencke, LMSW
• Colleen Kendall

• Oral and Maxillofacial Surgery (Dentist) in Boise, ID
• Providers in Boise, ID by specialty
• Oral and Maxillofacial Surgery (Dentist) in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.