Active NPI
Kenneth Evan Hardy, DDS
- Dentist
- Suffolk, VA
National Provider Identifier
1265494694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 05324
- Practice address
- 1622 Holland Rd
Suffolk, VA 23434 - Phone
- (757) 539-2998
- Fax
- (757) 539-0969
- NPI assigned
- Apr 3, 2006
- Last updated
- Jul 13, 2026
- 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 | 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150331000871 | VA | Order and Referring Only - Oral Surgery | 5395062400 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05324 | VA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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
- Harbour View Dental Center, PLC
- Harbour View Medical Center LLC (Bon Secours Harbour View Medical Center)
- Harbour View Oral & Facial Surgery PLLC
- James Bauss Harding, MD
- Anita Shanell Hardy
- Deja Hare
- Robert Earnest Hargraves Jr.
- Danelle Hargrove
- Colleen Michelle Harmon, PHARMD
- Harmony at Harbour View
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.