Bruce Edward Kennedy, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

13236 Issued in MI

Practice address

435 Pine St
Rochester, MI 48307-1933

Phone

(248) 652-9116

Fax

(248) 652-3136

NPI assigned

Jan 18, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• University Dental Assoc., PC

  • General Practice Dentistry
  • Rochester, MI
  • NPI 1689782849
  NPD (past)
• Walby Dental PLLC

  • General Practice Dentistry
  • Rochester, MI
  • NPI 1366172249
  NPD (past)

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770635658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4367 CREEKWOOD CT",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483064605",
            "telephone_number": "248-652-7754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 PINE ST",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071933",
            "telephone_number": "248-652-9116",
            "fax_number": "248-652-3136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "BRUCE",
        "middle_name": "EDWARD",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "13236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL",
            "identifier": "13236",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Paul Keller, R.PH.
• Michele Keller
• Brittany Lynn Kelly
• Claire Marie Kenaan, RPH
• Robert G Kender, PHD
• Ahmad Khasawneh
• Dina Khoury, DDS
• Janice Kilpatrick, LMSW
• Robin Nicole Kim, MA MFT
• Kindred Corner Counseling and Clinical Supervision PLLC

• General Practice Dentistry in Rochester, MI
• Providers in Rochester, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.