Deryl Palmer Kipp, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2767 Issued in ME

Practice address

765 High St
Bath, ME 04530-2496

Phone

(207) 443-3220

Fax

(207) 443-5462

NPI assigned

Nov 9, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1257724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257724800000",
    "number": "1609103803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 HIGH ST",
            "city": "BATH",
            "state": "ME",
            "postal_code": "045302496",
            "telephone_number": "207-443-3220",
            "fax_number": "207-443-5462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 HIGH ST",
            "city": "BATH",
            "state": "ME",
            "postal_code": "045302496",
            "telephone_number": "207-443-3220",
            "fax_number": "207-443-5462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIPP",
        "first_name": "DERYL",
        "middle_name": "PALMER",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-09",
        "last_updated": "2009-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "ME",
            "license": "2767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dusty Jones, DUSTY JONES
• Christina Anne Kapala, D.O.
• Karin Sinclair
• Lisa K Keiski, DO
• Mary L Kelley, LCPC
• Cathleen D Koslosky, NP
• Meghan Langella
• Margaret Lederfine Paskal, DO
• Loretta Morse Leighton, LCPC
• Cheryl Lierow, MS

• All providers in Bath, ME
• Oral and Maxillofacial Surgery (Dentist) in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2009; 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.