Gregory Lynn Kennedy, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3862 Issued in AL

Practice address

12475 US Highway 90
Grand Bay, AL 36541-5707

Phone

(251) 865-3500

NPI assigned

Oct 25, 2006

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 AL

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.

• Gregory L. Kennedy D.M.D PC

  • Dental Clinic/Center
  • Grand Bay, AL
  • NPI 1760116818
  NPD Authorized official

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1336223395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 629",
            "city": "GRAND BAY",
            "state": "AL",
            "postal_code": "365410629",
            "telephone_number": "251-865-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12475 US HIGHWAY 90",
            "city": "GRAND BAY",
            "state": "AL",
            "postal_code": "365415707",
            "telephone_number": "251-865-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "GREGORY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "3862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hart and Assoc
• Panya J Holmes, ARRT(R)(MR)(CT)
• Jordan Jackson, LPC
• Jakobs Home, LLC
• James M. Sitz DDS PC
• New Grand Bay Pharmacy, LLC
• William Christopher Patton, MD
• Alita M. Perry, R.PH.
• Shenavia Peyton
• Playful Minds Pediatric Therapy, LLC

• General Practice Dentistry in Grand Bay, AL
• Providers in Grand Bay, AL by specialty
• General Practice Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.