Individual provider Active NPI

Kenneth Ronald Wright, DMD, MPH

  • Periodontics
  • Leesburg, VA
National Provider Identifier
1487668430
Registry record updated Jul 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DN 11755 Issued in FL
Practice address
810 Fountain Hall CT NE
Leesburg, VA 20176-3650
Phone
(703) 669-1964
Fax
(703) 669-1964
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X DN 11755 FL Primary
Public Health Dentistry 1223D0001X DN 11755 FL

Addresses

Primary practice location

810 Fountain Hall CT NE
Leesburg, VA 20176-3650

Mailing address

810 Fountain Hall CT NE
Leesburg, VA 20176-3650
Phone (703) 669-1964

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
DN 11755FLMDPublic Health Dentist
DN 11755FLMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280188800000",
    "number": "1487668430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 FOUNTAIN HALL CT NE",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201763650",
            "telephone_number": "703-669-1964",
            "fax_number": "703-669-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 FOUNTAIN HALL CT NE",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201763650",
            "telephone_number": "703-669-1964",
            "fax_number": "703-669-1964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "KENNETH",
        "middle_name": "RONALD",
        "name_prefix": "Dr.",
        "credential": "DMD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2010-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN 11755",
            "primary": true
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "FL",
            "license": "DN  11755",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.