NPIMap

Organization Active NPI

Kennedy Dental Associates, P.C.

  • General Practice Dentistry
  • Bellevue, NE
National Provider Identifier
1679648521
Registry record updated May 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
KENNEDY DENTAL ASSOCIATES, P.C.
Practice address
1411 JF Kennedy Drive
Bellevue, NE 68005-3693
Phone
(402) 291-3535
Fax
(402) 291-0760
NPI assigned
Nov 22, 2006
Last updated
May 4, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2010

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

Authorized official

Name
Phil J Thomas, DDSNPI 1619042553
Title
Dentist President
Phone
(402) 291-3535

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

1411 JF Kennedy Drive
Bellevue, NE 68005-3693

Mailing address

1411 JF Kennedy Drive
Bellevue, NE 68005-3693
Phone (402) 291-3535

National Provider Directory

National Provider Directory

Locations

1411 J F Kennedy Dr
Bellevue, NE 68005
Phone (402) 291-3535

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272931200000",
    "number": "1679648521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 JF KENNEDY DRIVE",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "680053693",
            "telephone_number": "402-291-3535",
            "fax_number": "402-291-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 JF KENNEDY DRIVE",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "680053693",
            "telephone_number": "402-291-3535",
            "fax_number": "402-291-0760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEDY DENTAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2010-05-04",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "PHIL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DENTIST PRESIDENT",
        "authorized_official_telephone_number": "402-291-3535",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2010; 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.