Active NPI
Kenneth Lyon, DDS
- Dentist
- Barboursville, WV
National Provider Identifier
1578688339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2285
- Practice address
- 2A Mall Rd
Barboursville, WV 25504-1821 - Phone
- (304) 733-5500
- NPI assigned
- Mar 20, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2285 | WV | Primary |
Addresses
Primary practice location
2A Mall Rd
Barboursville, WV 25504-1821
Mailing address
5187 US RT 60
BLDG.3 Ste7 East Hills Professional Center
Huntington, WV 27504
Phone (304) 736-8620
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Sep 20, 2015 through Sep 20, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2285 | WV | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447718400000",
"number": "1578688339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5187 US RT 60",
"address_2": "BLDG.3 STE7 EAST HILLS PROFESSIONAL CENTER",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "27504",
"telephone_number": "304-736-8620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2A MALL RD",
"city": "BARBOURSVILLE",
"state": "WV",
"postal_code": "255041821",
"telephone_number": "304-733-5500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYON",
"first_name": "KENNETH",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-20",
"last_updated": "2015-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WV",
"license": "2285",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Barboursville, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2015; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.