Macie Lynn Kerr, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

109980 Issued in CA

Practice address

1158 Cirby Way Ste a
Roseville, CA 95661-4478

Phone

(916) 786-6676

NPI assigned

Jun 26, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gerwig Family Dental PLLC

  • Dentist
  • Lubbock, TX
  • NPI 1578893020
  NPD (past)

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

{
    "created_epoch": "1624665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1780254391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1158 CIRBY WAY STE A",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1158 CIRBY WAY STE A",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614478",
            "telephone_number": "916-786-6676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERR",
        "first_name": "MACIE",
        "middle_name": "LYNN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-26",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "37312",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "109980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth L. Larson, PH.D., Inc.
• Kenric a. Snow DDS Inc.
• Kenworthy Dental Corp
• Ruth Kenworthy, D.D.S.
• Brittany Kerr, LCSW
• Matthew Adam Kerr, D.P.T.
• Jon R Kerschner, MA
• Courtney L Kerstetter
• Lindsey Kerth, DPT
• Ardalan Keshtkar, D.D.S

• General Practice Dentistry in Roseville, CA
• Providers in Roseville, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.