Individual provider Active NPI

Paul Clifford Kitchin III, DDS

  • Dentist
  • King George, VA
National Provider Identifier
1629416508
Registry record updated Jun 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401004878 Issued in VA
Practice address
7450 Mattaponi LN
King George, VA 22485-3650
Phone
(540) 775-2201
NPI assigned
Jun 12, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401004878 VA Primary

Addresses

Primary practice location

7450 Mattaponi LN
King George, VA 22485-3650

Mailing address

7450 Mattaponi LN
King George, VA 22485-3650
Phone (540) 775-2201

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
0401004878VAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1629416508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7450 MATTAPONI LN",
            "city": "KING GEORGE",
            "state": "VA",
            "postal_code": "224853650",
            "telephone_number": "540-775-2201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7450 MATTAPONI LN",
            "city": "KING GEORGE",
            "state": "VA",
            "postal_code": "224853650",
            "telephone_number": "540-775-2201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITCHIN",
        "first_name": "PAUL",
        "middle_name": "CLIFFORD",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-12",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401004878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in King George, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; 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.