Kiersten Denise Bethea, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11493 Issued in NC

Practice address

1301 Fayetteville St
Durham, NC 27707-2325

Phone

(919) 956-4000

NPI assigned

Jul 1, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

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.

• Lincoln Community Health Center Incorporated

  • Federally Qualified Health Center (FQHC)
  • Durham, NC
  • NPI 1114978582
  Medicare reassignment NPD
• Lincoln Community Health Center Incorporated

  • Federally Qualified Health Center (FQHC)
  • Durham, NC
  • NPI 1114614518
  NPD

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

{
    "created_epoch": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1275195166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5119 CARLSON DAIRY RD",
            "city": "SUMMERFIELD",
            "state": "NC",
            "postal_code": "273589210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 FAYETTEVILLE ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072325",
            "telephone_number": "919-956-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETHEA",
        "first_name": "KIERSTEN",
        "middle_name": "DENISE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-01",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "11493",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "11493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Besuden
• Nicolas Jorge Betancourt, MD
• Beth Schmitt Consulting, PLLC
• Chloe Merritt Bethany
• Jasmine Shavon Bethea, MSW,LCSW,LCAS
• Laura C. Bethea
• Shakira B Bethea, LMBT
• Garrett Chase Bethel, MD
• M Bethel, M.D.
• Mikhail Alexander Bethell

• General Practice Dentistry in Durham, NC
• Providers in Durham, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; 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.

Verify at the official NPI Registry.