Raedeane Kenway

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

2902008900 Issued in MI

Practice address

8542 Holly Rd
Grand Blanc, MI 48439

Phone

(810) 603-7887

Fax

(810) 720-1306

NPI assigned

Feb 6, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Raedeane Macciomei Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Ebrahim Schmitt PLLC

  • General Practice Dentistry
  • Grand Blanc, MI
  • NPI 1023719960
  NPD (past)
• Great Lakes Family Dental Group - Grand Blanc

  • General Practice Dentistry
  • Grand Blanc, MI
  • NPI 1720323173
  NPD (past)

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

{
    "created_epoch": "1517875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517875200000",
    "number": "1336648393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8542 HOLLY RD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "48439",
            "telephone_number": "810-603-7887",
            "fax_number": "810-720-1306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8542 HOLLY RD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "48439",
            "telephone_number": "810-603-7887",
            "fax_number": "810-720-1306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENWAY",
        "first_name": "RAEDEANE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-06",
        "last_updated": "2018-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MI",
            "license": "2902008900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAEDEANE",
            "last_name": "MACCIOMEI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nicole Kemp
• Anne Elise Kender, DPT
• Seaera Sueann Kennedy
• Jennifer Lynn Kent-Bryant, LMSW
• Shanta Kent
• Kurt Keogh, MD
• Margee Keoshian
• Brittany Keough, CRNA
• Kayla Marie Kerch, MD
• Erin Kerns

• Dental Hygienist in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Dental Hygienist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.