Active NPI
Kerry G. Snow, D.M.D.
- General Practice Dentistry
- Breckenridge, TX
National Provider Identifier
1275790727
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 142901
- Practice address
- 2802 W Walker St
Breckenridge, TX 76424-4000 - Phone
- (254) 559-7215
- Fax
- (254) 559-7213
- NPI assigned
- May 21, 2008
- Last updated
- Aug 5, 2010
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 142901 | UT | Primary |
Addresses
Primary practice location
2802 W Walker St
Breckenridge, TX 76424-4000
Mailing address
2802 W Walker St
Ste 400
Breckenridge, TX 76424-4000
Phone (254) 559-7215
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 142901 | UT | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280966400000",
"number": "1275790727",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2802 W WALKER ST",
"address_2": "STE 400",
"city": "BRECKENRIDGE",
"state": "TX",
"postal_code": "764244000",
"telephone_number": "254-559-7215",
"fax_number": "254-559-7213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2802 W WALKER ST",
"city": "BRECKENRIDGE",
"state": "TX",
"postal_code": "764244000",
"telephone_number": "254-559-7215",
"fax_number": "254-559-7213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SNOW",
"first_name": "KERRY",
"middle_name": "G.",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-21",
"last_updated": "2010-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "UT",
"license": "142901",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Breckenridge, TX
- Cynthia Anne Perry, M.D.
- William Elmo Prater, M.D.
- Rachael Kendra Dabelic, M.D. P.a.
- Senior Health - Villa Haven, LLC
- Shackelford County Community Resource Center (ResourceCare Breckenridge)
- Stephens Memorial Hospital
- Stephens Memorial Hospital
- Stephens Memorial Hospital
- Stephens Memorial Hospital
- Stephens Memorial Hospital
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.