Individual provider Active NPI

Raymond David Kimberly, DDS

  • Dentist
  • Akron, OH
National Provider Identifier
1578746970
Registry record updated Dec 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30013105 Issued in OH
Practice address
1852 Merriman Road
Valley Dental Group Inc
Akron, OH 44313-5295
Phone
(330) 867-8354
Fax
(330) 867-6960
NPI assigned
Dec 10, 2007
Last updated
Dec 10, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30013105 OH Primary

Addresses

Primary practice location

1852 Merriman Road
Valley Dental Group Inc
Akron, OH 44313-5295

Mailing address

1852 Merriman Road
Valley Dental Group Inc
Akron, OH 44313-5295
Phone (330) 867-8354

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
30013105OHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Dental Group Inc. Dentist Past Accepting new patients
Valley Dental Group Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1197244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197244800000",
    "number": "1578746970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1852 MERRIMAN ROAD",
            "address_2": "VALLEY DENTAL GROUP INC",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443135295",
            "telephone_number": "330-867-8354",
            "fax_number": "330-867-6960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1852 MERRIMAN ROAD",
            "address_2": "VALLEY DENTAL GROUP INC",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443135295",
            "telephone_number": "330-867-8354",
            "fax_number": "330-867-6960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBERLY",
        "first_name": "RAYMOND",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-10",
        "last_updated": "2007-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30013105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2007; 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.