NPIMap

Organization Active NPI

Kenwood Dental Inc

  • Dentist
  • Duluth, MN
National Provider Identifier
1447408679
Registry record updated Jan 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D12071 Issued in MN
Legal business name
KENWOOD DENTAL INC
Practice address
1630 Kenwood Ave
Duluth, MN 55811-2222
Phone
(218) 728-4288
NPI assigned
Aug 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2014

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

Authorized official

Name
Kyle D KolquistNPI 1336285055
Title
Owner
Phone
(218) 728-4288

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X D12071 MN Primary

Addresses

Primary practice location

1630 Kenwood Ave
Duluth, MN 55811-2222

Mailing address

1630 Kenwood Ave
Duluth, MN 55811-2222
Phone (218) 728-4288

National Provider Directory

National Provider Directory

Locations

1630 Kenwood Ave
Duluth, MN 55811
Phone (218) 728-4288

Practitioners & affiliated clinicians

Practitioners 2

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": "1219968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388620800000",
    "number": "1447408679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 KENWOOD AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558112222",
            "telephone_number": "218-728-4288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 KENWOOD AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558112222",
            "telephone_number": "218-728-4288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENWOOD DENTAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-29",
        "last_updated": "2014-01-02",
        "status": "A",
        "authorized_official_last_name": "KOLQUIST",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-728-4288"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "D12071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2014; 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.