NPIMap

Organization Active NPI

K. Kevin Neshat, DDS, MD, PA

Doing business as Wendell Family Dentistry

  • General Practice Dentistry
  • Wendell, NC
National Provider Identifier
1629849088
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
K. KEVIN NESHAT, DDS, MD, PA
Doing business as
Wendell Family Dentistry
Practice address
3200 Wendell Blvd
Wendell, NC 27591-5908
Phone
(919) 365-3127
NPI assigned
Jan 12, 2024
Last updated
Jan 12, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
K. KEVIN NESHAT, DDS, MD, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Authorized official

Name
Gloria Bohne
Title
Director of RCM
Phone
(984) 308-0506

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

3200 Wendell Blvd
Wendell, NC 27591-5908

Mailing address

3200 Wendell Blvd
Wendell, NC 27591-5908
Phone (919) 365-3127

Other names 1

  • Wendell Family Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
K Kevin Neshat DDS MD PA3 organizations share this tax ID, including this one
Part of
K Kevin Neshat DDS MD PA

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1705017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705017600000",
    "number": "1629849088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 WENDELL BLVD",
            "city": "WENDELL",
            "state": "NC",
            "postal_code": "275915908",
            "telephone_number": "919-365-3127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 WENDELL BLVD",
            "city": "WENDELL",
            "state": "NC",
            "postal_code": "275915908",
            "telephone_number": "919-365-3127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K. KEVIN NESHAT, DDS, MD, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "K. KEVIN NESHAT, DDS, MD, PA",
        "enumeration_date": "2024-01-12",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A",
        "authorized_official_last_name": "BOHNE",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "DIRECTOR OF RCM",
        "authorized_official_telephone_number": "984-308-0506"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wendell Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wendell, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; 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.