Organization Active NPI

Kevin C. Dean, DMD PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Pensacola, FL
National Provider Identifier
1528345840
Registry record updated Nov 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DN12675 Issued in FL
Legal business name
KEVIN C. DEAN, DMD PA
Practice address
4850 N 9TH Ave Ste 4
Pensacola, FL 32503-2406
Phone
(850) 477-1125
Fax
(850) 479-5809
NPI assigned
Nov 15, 2011
Last updated
Nov 15, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2011

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

Authorized official

Name
Mrs. Lori Brock, MBA
Title
Manager
Phone
(850) 477-1125

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DN12675 FL Primary

Addresses

Primary practice location

4850 N 9TH Ave Ste 4
Pensacola, FL 32503-2406

Mailing address

4850 N 9TH Ave Ste 4
Pensacola, FL 32503-2406
Phone (850) 477-1125

Other identifiers 1

IdentifierTypeStateIssuer
0716316-00MedicaidFL

National Provider Directory

National Provider Directory

Locations

301 N Cedar St
Foley, AL 36535
Phone (251) 934-3381

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1321315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321315200000",
    "number": "1528345840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 N 9TH AVE STE 4",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032406",
            "telephone_number": "850-477-1125",
            "fax_number": "850-479-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 N 9TH AVE STE 4",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032406",
            "telephone_number": "850-477-1125",
            "fax_number": "850-479-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN C. DEAN, DMD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-15",
        "last_updated": "2011-11-15",
        "status": "A",
        "authorized_official_last_name": "BROCK",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "850-477-1125",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN12675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0716316-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2011; 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.