Individual provider Active NPI

Thomas Kenny, D.M.D.

  • Dentist
  • Las Vegas, NV
National Provider Identifier
1548638455
Registry record updated Sep 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6625 Issued in NV
Practice address
7398 Smoke Ranch Rd
100
Las Vegas, NV 89128-0256
Phone
(702) 254-7577
NPI assigned
Sep 9, 2015
Last updated
Sep 9, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6625 NV Primary

Addresses

Primary practice location

7398 Smoke Ranch Rd
100
Las Vegas, NV 89128-0256

Mailing address

7398 Smoke Ranch Rd
100
Las Vegas, NV 89128-0256

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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

Enrollment IDStateProvider typePAC IDDetails
I20160929001522 NV Order and Referring Only - DentistPractitioner - Dentist 7416244744

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6625NVMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1441756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441756800000",
    "number": "1548638455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7398 SMOKE RANCH RD",
            "address_2": "100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7398 SMOKE RANCH RD",
            "address_2": "100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280256",
            "telephone_number": "702-254-7577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNY",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-09",
        "last_updated": "2015-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "6625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.