Kumjohn Tanvishut, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

8689 Issued in NC

Practice address

5923 W Friendly Ave
Greensboro, NC 27410-3207

Phone

(336) 632-0744

Fax

(336) 632-0754

NPI assigned

Sep 9, 2008

Last updated

Sep 9, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Lane & Associates Xiii DDS PA

  • General Practice Dentistry
  • Greensboro, NC
  • NPI 1710031612
  NPD (past)
• Lane and Associates IX DDS PA

  • General Practice Dentistry
  • Biscoe, NC
  • NPI 1679626832
  NPD (past)
• Lane and Associates VI DDS PA

  • General Practice Dentistry
  • Durham, NC
  • NPI 1295990406

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220918400000",
    "number": "1598913006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2222",
            "city": "LILLINGTON",
            "state": "NC",
            "postal_code": "275462222",
            "telephone_number": "910-893-1096",
            "fax_number": "910-814-1559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5923 W FRIENDLY AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274103207",
            "telephone_number": "336-632-0744",
            "fax_number": "336-632-0754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANVISHUT",
        "first_name": "KUMJOHN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-09",
        "last_updated": "2008-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "8689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sigmund Ian Tannenbaum, MD
• Tanner and Monaghan, PLLC
• James H. Tanner, D.D.S., M.S.
• Madelyn Elizabeth Tanner, PA-C
• Michael C. Tanner, M.D.
• Jorge Luis Tapia Cedeno, PA-C
• Leisa Tapia, PA-C
• Target
• Tariq Jah, DDS, PLLC
• Ricquita Cheresa Tarpley-Carter, LCSWA

• Dentist in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.