Kenley D Michaud, D.D.S.

Primary specialty

Dental AnesthesiologyTaxonomy code 1223D0004X

License

1547 Issued in AK

Practice address

1231 W Northern Lights Blvd Ste 623
Anchorage, AK 99503-2337

Phone

(415) 375-0607

NPI assigned

May 1, 2014

Sex

Male

Sole proprietor

Yes

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

Practice roles

Locations

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.

• Northern Lights Dental Anesthesia, LLC

  • Dental Anesthesiology
  • Anchorage, AK
  • NPI 1437568409
  NPD Authorized official

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

{
    "created_epoch": "1398902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398902400000",
    "number": "1689084550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 W NORTHERN LIGHTS BLVD STE 623",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995032337",
            "telephone_number": "415-375-0607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 W NORTHERN LIGHTS BLVD STE 623",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995032337",
            "telephone_number": "415-375-0607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAUD",
        "first_name": "KENLEY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-01",
        "last_updated": "2014-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "AK",
            "license": "1547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Usoalii Michael
• Leslie K Michalski, LMT
• Angela Marie Michaud, BS, MBA, DC
• Carolyn Michaud, OTD OTR/L
• Donna Mukesh Michaud, PHARMD.
• Lois I Michaud, PHD
• Maurice Michael Michaud II, D.C.
• Stephanie Ann Michel, BS
• Michelle B. Burch- Speech-Language Pathologist
• Michelle Bauer

• Dental Anesthesiology in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Dental Anesthesiology in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2014; 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.