Kenneth C Pinkerton, DMD

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

Practice address

10200 West Main Street
Signal Hill Medical Building
Belleville, IL 62223-1495

Phone

(618) 397-2464

Fax

(618) 398-4450

NPI assigned

Oct 16, 2006

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

Other identifiers 2

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.

• Center for Oral and Maxillofacial Surgery, P.C.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Belleville, IL
  • NPI 1801000443
  NPD (past)
• Oral Facial Surgery Institute of Illinois P C

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Belleville, IL
  • NPI 1740697333
  NPD (past)

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396835583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 WEST MAIN STREET",
            "address_2": "SIGNAL HILL MEDICAL BUILDING",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622231495",
            "telephone_number": "618-397-2464",
            "fax_number": "618-398-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 WEST MAIN STREET",
            "address_2": "SIGNAL HILL MEDICAL BUILDING",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622231495",
            "telephone_number": "618-397-2464",
            "fax_number": "618-398-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINKERTON",
        "first_name": "KENNETH",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "985218",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS BLUE SHIELD",
            "identifier": "80115934",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Edith Phelps, PTA
• Physicians Surgical Center, LLC
• Physicians' Surgical Center LLC
• Michelle Pickering, PT
• Frank Pikul, M.D.
• Tracie Leigh Placher
• Plastic & Hand Surgery Associates, S.C.
• Plastic Surgery Consultants, P.C.
• Irina Y Polansky, PA-C
• Jamie Marie Poorman, PT, DPT

• Oral & Maxillofacial Surgery (D.M.D.) in Belleville, IL
• Providers in Belleville, IL by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Illinois

• 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.