Individual provider Active NPI

Kenneth Corey Warden, D.D.S.

  • General Practice Dentistry
  • Westerville, OH
National Provider Identifier
1407118391
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.023769 Issued in OH
Practice address
631 Copeland Mill Rd Ste a
Westerville, OH 43081-8905
Phone
(614) 899-9200
NPI assigned
Jun 15, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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 30.023769 OH Primary

Addresses

Primary practice location

631 Copeland Mill Rd Ste a
Westerville, OH 43081-8905

Mailing address

631 Copeland Mill Rd Ste a
Westerville, OH 43081-8905
Phone (614) 899-9200

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
30.023769OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1339718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1407118391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 COPELAND MILL RD STE A",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430818905",
            "telephone_number": "614-899-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 COPELAND MILL RD STE A",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430818905",
            "telephone_number": "614-899-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARDEN",
        "first_name": "KENNETH",
        "middle_name": "COREY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-15",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.023769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westerville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2021; 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.