Kerry D Kennedy, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

A495 Issued in AK

Practice address

625 E 34TH Ave
Anchorage, AK 99503-4117

Phone

(907) 277-5684

Fax

(907) 277-5694

NPI assigned

Aug 18, 2005

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

Medicare fee-for-service enrollment

Enrolled in AK

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

State licenses

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295727907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 E 34TH AVE",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995034117",
            "telephone_number": "907-277-5684",
            "fax_number": "907-277-5694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 E 34TH AVE",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995034117",
            "telephone_number": "907-277-5684",
            "fax_number": "907-277-5694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "KERRY",
        "middle_name": "D",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AK",
            "license": "A495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Joyce Kenna, DPT
• Skyler Kenna, PA-C
• Benjamin L Kennah, PA-C
• Ekaterina Kennedy
• Joshua Michael Kennedy, D.M.D.
• Pamela Ann Kennedy, M.S.
• Roisin N Kennedy, DC
• Alison A Kennen, MS
• Kenneth R Pervier, MD, LLC
• Kenneth Y K Chang Accent on Dentistry

• Dentist in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Dentist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.