Paul Francis Kenworthy, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

016-0000975 Issued in VT

Practice address

1 Kennedy Dr # LL4
South Burlington, VT 05403-7152

Phone

(888) 720-5832

Fax

(888) 965-5114

NPI assigned

Apr 30, 2006

Last updated

Mar 17, 2018By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Paul Kenworthy DMD, PC

  • Customized Equipment (DME)
  • South Burlington, VT
  • NPI 1780196329
  Authorized official Same address or phone

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

{
    "created_epoch": "1146355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1336106525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KENNEDY DR # LL4",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054037152",
            "telephone_number": "888-720-5832",
            "fax_number": "888-965-5114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KENNEDY DR # LL4",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054037152",
            "telephone_number": "888-720-5832",
            "fax_number": "888-965-5114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Place Notre Dame",
            "address_purpose": "LOCATION",
            "city": "St Johnsbury",
            "state": "VT",
            "postal_code": "058192223",
            "country_code": "US",
            "telephone_number": "888-720-5832",
            "fax_number": "888-965-5114",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5043 US Route 5",
            "address_purpose": "LOCATION",
            "city": "Newport",
            "state": "VT",
            "postal_code": "058559843",
            "country_code": "US",
            "telephone_number": "888-720-5832",
            "fax_number": "888-965-5114",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4 Kellogg Rd",
            "address_purpose": "LOCATION",
            "city": "Essex Jct",
            "state": "VT",
            "postal_code": "054522815",
            "country_code": "US",
            "telephone_number": "888-720-5832",
            "fax_number": "888-965-5114",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "142 Boynton Ave",
            "address_purpose": "LOCATION",
            "city": "Plattsburgh",
            "state": "NY",
            "postal_code": "129011292",
            "country_code": "US",
            "telephone_number": "888-720-5832",
            "fax_number": "888-965-5114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENWORTHY",
        "first_name": "PAUL",
        "middle_name": "FRANCIS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-30",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VT",
            "license": "016-0000975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0002551",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID # ASSOCIATED WITH A REASSIGNMENT OF BENEFITS",
            "identifier": "Y400189729",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer J Kelly, DO
• Barbara C Kennedy, MD
• Karen D Kennedy, PT
• Kathryn Kennedy, DC
• Edward F. Kent Jr., MD
• Kenneth Kero, DDS
• Diane Pamela Kerr, RN BSN
• Alexandria Kerrigan, LICSW
• Kevin Nielsen Counseling
• Seohyun Kim

• General Practice Dentistry in South Burlington, VT
• Providers in South Burlington, VT by specialty
• General Practice Dentistry in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.