Individual provider Active NPI

Kenneth Evan Hardy, DDS

  • Dentist
  • Suffolk, VA
National Provider Identifier
1265494694
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
05324 Issued in VA
Practice address
1622 Holland Rd
Suffolk, VA 23434
Phone
(757) 539-2998
Fax
(757) 539-0969
NPI assigned
Apr 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 05324 VA Primary

Addresses

Primary practice location

1622 Holland Rd
Suffolk, VA 23434

Mailing address

1622 Holland Rd
Suffolk, VA 23434
Phone (757) 539-2998

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20150331000871 VA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5395062400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05324VAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
James Alan Taylor Dentist Past Accepting new patients

Organizations & group practices 1

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": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1265494694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1622 HOLLAND RD",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "23434",
            "telephone_number": "757-539-2998",
            "fax_number": "757-539-0969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1622 HOLLAND RD",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "23434",
            "telephone_number": "757-539-2998",
            "fax_number": "757-539-0969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDY",
        "first_name": "KENNETH",
        "middle_name": "EVAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "05324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.