Thomas Michael Kennedy, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12007951 Issued in IN

Practice address

1261 Clifty Hollow Rd
Madison, IN 47250-3049

Phone

(812) 265-6411

Fax

(812) 265-4392

NPI assigned

Mar 26, 2007

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

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1699892281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1261 CLIFTY HOLLOW RD",
            "city": "MADISON",
            "state": "IN",
            "postal_code": "472503049",
            "telephone_number": "812-265-6411",
            "fax_number": "812-265-4392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1261 CLIFTY HOLLOW RD",
            "city": "MADISON",
            "state": "IN",
            "postal_code": "472503049",
            "telephone_number": "812-265-6411",
            "fax_number": "812-265-4392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "THOMAS",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12007951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethany R Johnson, LCSW
• Renee E Johnson, LCSW
• Whitney Renee Johnson, MS, CCC-SLP
• Ajay K Kandra, MD
• Ronald G. Kearschner, M.D.
• Kevin L. Klinedinst DDS PC
• Magdy W Khalil, M.D.
• A Nicole Kilburn, MSSW
• Heather R Kindoll
• Robert Wayne Kirkpatrick, OD

• General Practice Dentistry in Madison, IN
• Providers in Madison, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.