Matthew Kanetsky, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30.023049 Issued in OH

Practice address

17273 State Route 104
Chillicothe, OH 45601-9718

Phone

(740) 773-1141

NPI assigned

Jun 15, 2009

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

Medicare fee-for-service enrollment

Enrolled in TX

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": "1245024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346889600000",
    "number": "1356578512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17273 STATE ROUTE 104",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456019718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17273 STATE ROUTE 104",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456019718",
            "telephone_number": "740-773-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANETSKY",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-15",
        "last_updated": "2012-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.023049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samer S Kabbani, M.D.
• Heather Marie Kallies, DDS
• Sean Kallner
• Sonia Kallner
• Katherine Lee Kaminski, LISW
• Rahul Kar, M.D.
• Neslihan Karakan
• Lindsey Karnes, CNP
• Annamarie Lauren Karr, CNP
• Sari Kaufman, LMSW

• General Practice Dentistry in Chillicothe, OH
• Providers in Chillicothe, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2012; 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.