Individual provider Active NPI

Kevin P Conroy, DMD

  • General Practice Dentistry
  • Billings, MT
National Provider Identifier
1356375661
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1552 Issued in MT
Practice address
1540 Lake Elmo Dr
Suite #2
Billings, MT 59105-1797
Phone
(406) 252-4200
Fax
(406) 252-9002
NPI assigned
Jul 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1552 MT Primary

Addresses

Primary practice location

1540 Lake Elmo Dr
Suite #2
Billings, MT 59105-1797

Mailing address

1540 Lake Elmo Dr
Suite #2
Billings, MT 59105-1797
Phone (406) 252-4200

Other identifiers 1

IdentifierTypeStateIssuer
129155MedicaidMT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1552MTMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356375661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 LAKE ELMO DR",
            "address_2": "SUITE #2",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591051797",
            "telephone_number": "406-252-4200",
            "fax_number": "406-252-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 LAKE ELMO DR",
            "address_2": "SUITE #2",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591051797",
            "telephone_number": "406-252-4200",
            "fax_number": "406-252-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONROY",
        "first_name": "KEVIN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MT",
            "license": "1552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129155",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Billings, MT

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.