Brooke Lee Kennedy, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

28091 Issued in TX

Practice address

3091 College Park Dr Ste 125
The Woodlands, TX 77384-8024

Phone

(936) 271-3338

NPI assigned

Jul 10, 2012

Sex

Female

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

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.

• North Forest Family Dental Care

  • Dental Clinic/Center
  • The Woodlands, TX
  • NPI 1356387906
  NPD (past)

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

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456790400000",
    "number": "1427313998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3091 COLLEGE PARK DR",
            "address_2": "STE 125",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773848024",
            "telephone_number": "936-271-3338",
            "fax_number": "936-271-3320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3091 COLLEGE PARK DR STE 125",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773848024",
            "telephone_number": "936-271-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "BROOKE",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-10",
        "last_updated": "2016-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "28091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooke Elizabeth Jane Kelly, D.C., D.V.C.
• Gerise Kemp, PHARMD
• Kendra Pratt Manning, DDS, Ms, PA (Terramont Orthodontics)
• John Paul Kendrick, LCSW
• Megan Blair Kennedy Shedden, P.A.C.
• Hunter G Kennedy, PSY.D., LPC
• Katherine Kennedy, CPNP
• Kristin Kenny, LPC
• Gloria T. Keraga, MD
• Dationna Kerr

• Dentist in The Woodlands, TX
• Providers in The Woodlands, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; 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.