Charles Michael Kenney, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

13988 Issued in TX

Practice address

17721 Dallas Pkwy Ste 116
Dallas, TX 75287-7338

Phone

(469) 685-1700

Fax

(888) 491-6582

NPI assigned

Feb 22, 2009

Sex

Male

Sole proprietor

No

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 TX

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 and National Provider Directory roles.

• John Russell Gilmore, M.D.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Dallas, TX
  • NPI 1194778928
  Medicare reassignment
• Cmkdds

  • Dentist
  • Dallas, TX
  • NPI 1316452667
  NPD (past) Authorized official

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

{
    "created_epoch": "1235260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1609016229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3328 GATWICK PL",
            "city": "FARMERS BRANCH",
            "state": "TX",
            "postal_code": "752342248",
            "telephone_number": "214-478-0701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17721 DALLAS PKWY STE 116",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752877338",
            "telephone_number": "469-685-1700",
            "fax_number": "888-491-6582"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1022 N Montclair Ave",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752083517",
            "country_code": "US",
            "telephone_number": "214-948-0206",
            "fax_number": "214-484-7118",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1022 N Montclair Ave",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752083517",
            "country_code": "US",
            "telephone_number": "214-948-0206",
            "fax_number": "214-484-7118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEY",
        "first_name": "CHARLES",
        "middle_name": "MICHAEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-22",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "13988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth S Bayles DO PA
• Kenneth S. Siedler, Psy.D., LLC
• Kenneth Trevino, PH.D., PLLC
• Angela Kenney, FNP
• Bruce Kenney
• Julia Brooke Kenney, M.A., CCC-SLP
• Michael Patrick Kenny, MMT, MT-BC
• Sarah Elizabeth Kenny, MD
• Mi Sun Kensing, DO
• Kent B Turner M D P a

• General Practice Dentistry in Dallas, TX
• Providers in Dallas, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; 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.