David Kernodle, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

1904 Issued in AR

Practice address

708 E Dixon Rd
Little Rock, AR 72206-4114

Phone

(877) 227-9892

Fax

(623) 321-6268

NPI assigned

May 17, 2010

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Cooper Matone Dental Care PC

  • General Practice Dentistry
  • Little Rock, AR
  • NPI 1790918449
  NPD (past)

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

{
    "created_epoch": "1274054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274054400000",
    "number": "1457679342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1904 W PARKSIDE LN",
            "address_2": "SUITE 201",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850271228",
            "telephone_number": "800-409-2563",
            "fax_number": "623-321-6268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 E DIXON RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722064114",
            "telephone_number": "877-227-9892",
            "fax_number": "623-321-6268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERNODLE",
        "first_name": "DAVID",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-17",
        "last_updated": "2010-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "1904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Ann Keough
• Jacqueline Alexandra Kepler, MD
• Trevor Todd Kepler
• Anna Kathleen Kerley, APRN
• Nathan A Kerley
• Miranda Kerperien
• Holly Arlene Kerr, PTA
• Lawrence Marvin Kerr, MSPT
• Robert Kerr, MD
• Lakendra Kertis

• Dentist in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Dentist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2010; 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.