Individual provider Active NPI

Kevin Lamar Golden, DMD

  • General Practice Dentistry
  • Charlotte, NC
National Provider Identifier
1467023622
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13130 Issued in NC
Practice address
8956 J M Keynes Dr Ste 500
Charlotte, NC 28262-8626
Phone
(980) 890-7590
NPI assigned
Jul 8, 2021
Last updated
Mar 9, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9928 SC
General Practice Dentistry 1223G0001X 13130 NC Primary

Addresses

Primary practice location

8956 J M Keynes Dr Ste 500
Charlotte, NC 28262-8626

Mailing address

2617 Ensemble CT
Charlotte, NC 28262-2043
Phone (770) 689-8150

Other practice location 1

9709 Red Stone Dr
Ste 500
Indian Land, SC 29707
Phone (803) 753-1349

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9928SCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ali Shahrestani, D.M.D., PLLC CurrentSince Mar 12, 2023 Accepting new patients
Kevin L Golden DMD PLLC General Practice CurrentSince Apr 23, 2023 Accepting new patients
Fort Mill Smiles Dentistry, PC General Practice PastSince Jul 1, 2021 Accepting new patients

Locations

8956 J M Keynes Dr
Ste 500
Charlotte, NC 28262
Phone (980) 890-7590

5965 Thunder Rd
Ste C
Concord, NC 28027
Phone (704) 610-8444

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1625702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1467023622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2617 ENSEMBLE CT",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282622043",
            "telephone_number": "770-689-8150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8956 J M KEYNES DR STE 500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282628626",
            "telephone_number": "980-890-7590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9709 Red Stone Dr",
            "address_2": "Ste 500",
            "address_purpose": "LOCATION",
            "city": "Indian Land",
            "state": "SC",
            "postal_code": "29707",
            "country_code": "US",
            "telephone_number": "803-753-1349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDEN",
        "first_name": "KEVIN",
        "middle_name": "LAMAR",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-08",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "9928",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "13130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; 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.