Gregory L. Kennedy D.M.D PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

GREGORY L. KENNEDY D.M.D PC

Practice address

12475 US Highway 90
Grand Bay, AL 36541-5796

Phone

(251) 865-3500

Fax

(251) 865-1101

NPI assigned

Jul 14, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Gregory L Kennedy, DMDNPI 1336223395

Title

Doctor / Owner

Phone

(251) 865-3500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Grand Bay Dental Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gregory Lynn Kennedy, D.M.D.

  • General Practice Dentistry
  • Grand Bay, AL
  • NPI 1336223395
  NPD Authorized official

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

{
    "created_epoch": "1657756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657756800000",
    "number": "1760116818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 628",
            "city": "GRAND BAY",
            "state": "AL",
            "postal_code": "365410628",
            "telephone_number": "251-865-3500",
            "fax_number": "251-865-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12475 US HIGHWAY 90",
            "city": "GRAND BAY",
            "state": "AL",
            "postal_code": "365415796",
            "telephone_number": "251-865-3500",
            "fax_number": "251-865-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY L. KENNEDY D.M.D PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-14",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DOCTOR / OWNER",
        "authorized_official_telephone_number": "251-865-3500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "3862",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Bay Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Penny Xuan Dupre, M.D.
• Vantrell Terrell Fox
• Grand Bay Convalescent Home Inc
• Grand Bay Medical Center, Inc.
• Greenway Health and Rehabilitation Center LLC
• Gulf Coast Treatment Center
• Hart & Associates
• Hart and Assoc
• Panya J Holmes, ARRT(R)(MR)(CT)
• Jordan Jackson, LPC

• Dental Clinic/Center in Grand Bay, AL
• Providers in Grand Bay, AL by specialty
• Dental Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; 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.