Organization Active NPI

William D Kenfield DDS LLC

  • General Practice Dentistry
  • Spencer, IN
National Provider Identifier
1447501358
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12007873 Issued in IN
Legal business name
WILLIAM D KENFIELD DDS LLC
Practice address
77 Fairview Ave
Spencer, IN 47460-1513
Phone
(812) 829-4886
Fax
(812) 829-4686
NPI assigned
Oct 2, 2012
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. William D Kenfield, DDS LLC
Title
Member
Phone
(812) 829-4886

Practitioners 2

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

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 12007873 IN Primary

Addresses

NPPES NPI Registry

Primary practice location

77 Fairview Ave
Spencer, IN 47460-1513

Mailing address

77 Fairview Ave
Spencer, IN 47460-1513
Phone (812) 829-4886

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
100195260AMedicaidIN

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 2, 2012.

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349136000000",
    "number": "1447501358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 FAIRVIEW AVE",
            "city": "SPENCER",
            "state": "IN",
            "postal_code": "474601513",
            "telephone_number": "812-829-4886",
            "fax_number": "812-829-4686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 FAIRVIEW AVE",
            "city": "SPENCER",
            "state": "IN",
            "postal_code": "474601513",
            "telephone_number": "812-829-4886",
            "fax_number": "812-829-4686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM D KENFIELD DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-02",
        "last_updated": "2012-10-02",
        "status": "A",
        "authorized_official_last_name": "KENFIELD",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "812-829-4886",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS LLC"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12007873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100195260A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spencer, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; 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.