Kenneth Ray Tripp Jr., DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

#6308 Issued in NC

Practice address

1906 S Main St
Suite 218
Wake Forest, NC 27587-5032

Phone

(919) 556-5566

Fax

(919) 562-5537

NPI assigned

Dec 8, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in NC

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kenneth R. Tripp. Jr. DDS, PA

  • General Practice Dentistry
  • Wake Forest, NC
  • NPI 1891840534
  NPD (past) Authorized official

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447319124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 S MAIN ST",
            "address_2": "SUITE 218",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275875032",
            "telephone_number": "919-556-5566",
            "fax_number": "919-562-5537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 S MAIN ST",
            "address_2": "SUITE 218",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275875032",
            "telephone_number": "919-556-5566",
            "fax_number": "919-562-5537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIPP",
        "first_name": "KENNETH",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "#6308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Triangle Diabetic Supply
• Triangle Pathway Therapy
• Triangle Primary Care Associates, PLLC
• Triangle Vision Care, O.D., P.a.
• Mark Lendyl Naguit Trinidad
• Matthew Charles Trojanowski, D.D.S.
• Todd Tronzo, LMFTA
• True Outreach
• Elizabeth Truitt
• Jennifer L Tun, PT

• General Practice Dentistry in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• General Practice Dentistry in North Carolina

• 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.
• 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.