NPIMap

Organization Active NPI

Kenneth J Patterson DDS LLC

  • Dentist
  • Muncie, IN
National Provider Identifier
1417330481
Registry record updated Jul 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12011558A Issued in IN
Legal business name
KENNETH J PATTERSON DDS LLC
Practice address
1608 W Yale Ave
Muncie, IN 47304-1569
Phone
(765) 288-4882
NPI assigned
Jul 8, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2015

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

Authorized official

Name
Kenneth J Patterson, DDS
Title
Owner
Phone
(765) 288-4882

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 12011558A IN Primary

Addresses

Primary practice location

1608 W Yale Ave
Muncie, IN 47304-1569

Mailing address

1608 W Yale Ave
Muncie, IN 47304-1569
Phone (765) 288-4882

National Provider Directory

National Provider Directory

Locations

1608 W Yale Ave
Muncie, IN 47304
Phone (765) 288-4882

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1436313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436313600000",
    "number": "1417330481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 W YALE AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473041569",
            "telephone_number": "765-288-4882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 W YALE AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473041569",
            "telephone_number": "765-288-4882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH J PATTERSON DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-08",
        "last_updated": "2015-07-08",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-288-4882",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011558A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muncie, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2015; 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.