Cecilia Kendrick, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

30.027791 Issued in OH

Practice address

4122 Hunt Rd
Blue Ash, OH 45236-1159

Phone

(513) 828-6708

NPI assigned

Jul 3, 2024

Last updated

Feb 19, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

Locations

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.

• Nguyen Blue Ash Modern Dentistry PC, Inc.

  • General Practice Dentistry
  • Blue Ash, OH
  • NPI 1619625134
  NPD

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

{
    "created_epoch": "1719964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1487490025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E 11TH ST",
            "city": "NEWPORT",
            "state": "KY",
            "postal_code": "410712203",
            "telephone_number": "859-655-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4122 HUNT RD",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452361159",
            "telephone_number": "513-828-6708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENDRICK",
        "first_name": "CECILIA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-03",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.027791",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "11170",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Keith, PHARMD.
• Amanda Keller, MA, LPC
• Kelly Grover Counseling LLC
• David Charles Kelly Jr.
• Lisa Diane Kelly, M.D.
• Kennedy Heights Counseling Services LLC
• Amanda Lauren Kennedy, AGACNP-BC
• Eboni Kennedy, RN
• Gracelyn Rose Kephart, CT
• Tyler Travis Kerr, OD

• Dentist in Blue Ash, OH
• Providers in Blue Ash, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.