Individual provider Active NPI

Kenneth James Harden, DDS., P.C.

  • General Practice Dentistry
  • Detroit, MI
National Provider Identifier
1639389299
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13687 Issued in MI
Practice address
7411 John R St
Detroit, MI 48202-3117
Phone
(313) 871-4405
Fax
(313) 871-7223
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 13687 MI Primary

Addresses

Primary practice location

7411 John R St
Detroit, MI 48202-3117

Mailing address

7411 John R St
Detroit, MI 48202-3117
Phone (313) 871-4405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20180219000749 MI Practitioner - Dentist 6608194675 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13687MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Harden Family Dentistry PC General Practice CurrentSince Nov 14, 2017 Accepting new patients

Locations

7411 John R St
Detroit, MI 48202
Phone (313) 871-4405

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639389299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7411 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023117",
            "telephone_number": "313-871-4405",
            "fax_number": "313-871-7223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7411 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023117",
            "telephone_number": "313-871-4405",
            "fax_number": "313-871-7223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDEN",
        "first_name": "KENNETH",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DDS., P.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "13687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.