Active NPI
Kendan Angel, DMD
- Dentist
- Harlan, KY
National Provider Identifier
1376228668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 10983
- Practice address
- 400 Village Center Rd
Harlan, KY 40831-1804 - Phone
- (606) 404-5052
- NPI assigned
- Jun 15, 2023
- Last updated
- Jan 6, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 10983 | KY | Primary |
Addresses
Primary practice location
400 Village Center Rd
Harlan, KY 40831-1804
Mailing address
160 Walnut Loop
Harlan, KY 40831-7235
Phone (859) 200-0410
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
| License | State | Type | Specialty |
|---|---|---|---|
| 10983 | KY | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Angel Dental LLC | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Harlan, KY
- NPI 1154191567
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704499200000",
"number": "1376228668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "160 WALNUT LOOP",
"city": "HARLAN",
"state": "KY",
"postal_code": "408317235",
"telephone_number": "859-200-0410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 VILLAGE CENTER RD",
"city": "HARLAN",
"state": "KY",
"postal_code": "408311804",
"telephone_number": "606-404-5052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANGEL",
"first_name": "KENDAN",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-06-15",
"last_updated": "2024-01-06",
"certification_date": "2024-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KY",
"license": "10983",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Harlan, KY
- Nazneen Ahmed, DO
- Air Evac EMS Inc. (Air Evac Lifeteam)
- Abiodun Enitan Akisanya, MD
- All American Oxygen, Inc (AeroCare Home Medical Equipment)
- Angel Dental LLC
- Appalachian Community Care LLC
- Appalachian Regional Healthcare Inc (Harlan Arh Pharmacy)
- Appalachian Regional Healthcare Inc (Harlan ARH Hospital)
- Appalachian Regional Healthcare Inc. (Harlan ARH Hospital)
- Appalachian Regional Healthcare Inc. (Harlan Arh Home Health Agency)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.