Kevin Russell Duniven, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2012015445 Issued in MO

Practice address

11426 Gravois Rd
Suite 202
Saint Louis, MO 63126-3656

Phone

(314) 962-1574

Fax

(314) 962-8585

NPI assigned

May 23, 2012

Sex

Male

Sole proprietor

Yes

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 MO

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

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

{
    "created_epoch": "1337731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444608000000",
    "number": "1316207475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11426 GRAVOIS RD",
            "address_2": "SUITE 202",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631263656",
            "telephone_number": "314-962-1574",
            "fax_number": "314-962-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11426 GRAVOIS RD",
            "address_2": "SUITE 202",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631263656",
            "telephone_number": "314-962-1574",
            "fax_number": "314-962-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNIVEN",
        "first_name": "KEVIN",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-23",
        "last_updated": "2015-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2012015445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Katherine Dunham, MSN, RN, BC-ANP
• Steven Richard Dunham Jr., MD
• Robert Dunigan, MD
• Brooklyn Dunihoo
• Caitlin Elisabeth Duniven, M.A.
• Dunlap Physical Therapy and Wellness
• Bonnie R Dunlap, MEDICAL DOCTOR
• Kathleen Dunlap, DPT
• Dunn-Dunn House LLC
• Bradley Jess Dunn, L.C.S.W.

• General Practice Dentistry in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2015; 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.