Active NPI
James Henry Kennedy, DDS
- Dentist
- Eaton, CO
National Provider Identifier
1790767788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 8230
- Practice address
- 100 S Cherry Ave
Unit 2 Suite a
Eaton, CO 80615-8253 - Phone
- (970) 454-3341
- Fax
- (970) 454-3393
- NPI assigned
- Nov 16, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 8230 | CO | Primary |
Addresses
Primary practice location
100 S Cherry Ave
Unit 2 Suite a
Eaton, CO 80615-8253
Mailing address
100 S Cherry Ave
Unit 2 Suite a
Eaton, CO 80615-8253
Phone (970) 454-3341
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160421000626 | CO | Order and Referring Only - Dentist | 9739487992 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8230 | CO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1790767788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 S CHERRY AVE",
"address_2": "UNIT 2 SUITE A",
"city": "EATON",
"state": "CO",
"postal_code": "806158253",
"telephone_number": "970-454-3341",
"fax_number": "970-454-3393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 S CHERRY AVE",
"address_2": "UNIT 2 SUITE A",
"city": "EATON",
"state": "CO",
"postal_code": "806158253",
"telephone_number": "970-454-3341",
"fax_number": "970-454-3393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "JAMES",
"middle_name": "HENRY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-16",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "8230",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Eaton, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.