NPIMap

Organization Active NPI

Kendrick & Jones Dental, LLC

  • General Practice Dentistry
  • Springfield, IL
National Provider Identifier
1770729253
Registry record updated Jan 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019016476 Issued in IL
Legal business name
KENDRICK & JONES DENTAL, LLC
Practice address
1226 N Ledlie Ave
Springfield, IL 62702-2542
Phone
(217) 525-6872
NPI assigned
Jan 5, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2009

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

Authorized official

Name
Dr. Samuel D. Kendrick, DMDNPI 1245301043
Title
Managing Member
Phone
(217) 525-6872

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 DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 019016476 IL Primary

Addresses

Primary practice location

1226 N Ledlie Ave
Springfield, IL 62702-2542

Mailing address

1226 N Ledlie Ave
Springfield, IL 62702-2542
Phone (217) 525-6872

National Provider Directory

National Provider Directory

Locations

1226 N Ledlie Ave
Springfield, IL 62702
Phone (217) 525-6872

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1231113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231113600000",
    "number": "1770729253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1226 N LEDLIE AVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627022542",
            "telephone_number": "217-525-6872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1226 N LEDLIE AVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627022542",
            "telephone_number": "217-525-6872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENDRICK & JONES DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-05",
        "last_updated": "2009-01-05",
        "status": "A",
        "authorized_official_last_name": "KENDRICK",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "217-525-6872",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019016476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2009; 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.