Individual provider Active NPI

Kenneth Alan Bell, DMD

  • General Practice Dentistry
  • Gainsville, FL
National Provider Identifier
1588649883
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6557 Issued in KY
Practice address
1601 S. W. Archer Road
Gainsville, FL 32608-1197
Phone
(904) 475-5800
Fax
(904) 475-5804
NPI assigned
Dec 8, 2005
Last updated
Oct 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6557 KY
General Practice Dentistry 1223G0001X 6557 KY Primary

Addresses

Primary practice location

1601 S. W. Archer Road
Gainsville, FL 32608-1197

Mailing address

1536 N Jefferson St
Jacksonville, FL 32209-6525
Phone (904) 475-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20221102003098 KY Order and Referring Only - DentistPractitioner - Dentist 0749657872

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6557KYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1588649883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1536 N JEFFERSON ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096525",
            "telephone_number": "904-475-5800",
            "fax_number": "904-475-5804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 S. W. ARCHER ROAD",
            "city": "GAINSVILLE",
            "state": "FL",
            "postal_code": "326081197",
            "telephone_number": "904-475-5800",
            "fax_number": "904-475-5804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELL",
        "first_name": "KENNETH",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-08",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "6557",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "6557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainsville, FL

Sources for this page

Verify at the official NPI Registry.