Kenneth Killpack, DDS, P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

KENNETH KILLPACK, DDS, P.C.

Doing business as

Affordable Dentures & Implants - Vancouver

Practice address

13503 SE Mill Plain Blvd Ste B2
Vancouver, WA 98684-6992

Phone

(360) 254-1307

NPI assigned

Aug 19, 2024

Organization subpart

No

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

Authorized official

Name

Kenneth Killpack, DDS

Title

Owner

Phone

(360) 254-1307

Specialties & licenses 1

Addresses

Other names 1

• Affordable Dentures & Implants - Vancouver Doing business as

Locations

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

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724025600000",
    "number": "1508698374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13503 SE MILL PLAIN BLVD STE B2",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986846992",
            "telephone_number": "360-254-1307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13503 SE MILL PLAIN BLVD STE B2",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986846992",
            "telephone_number": "360-254-1307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH KILLPACK, DDS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A",
        "authorized_official_last_name": "KILLPACK",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-254-1307",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Affordable Dentures & Implants - Vancouver",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Myrna Astraea Kennedy, MSABA, BCBA, LBA
• Nicole Rose Kennedy, LMHCA
• Scott Richard Kennedy, MD
• Tara Lynn Kennedy, MA
• Kenneth a Shultz Edd PS
• Sheryl Elizabeth Kennon, B.S.
• John Stephen Kenny, DDS
• Kurt W Kenoyer, PA-C
• Ashrielle Kent
• Carrie M Kent, DO

• General Practice Dentistry in Vancouver, WA
• Providers in Vancouver, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.