Individual provider Active NPI

Justin Paul Kenney, DMD

  • General Practice Dentistry
  • Allentown, PA
National Provider Identifier
1801946587
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS036057 Issued in PA
Practice address
431 Haines Mill Rd
Allentown, PA 18104
Phone
(610) 432-1228
Fax
(610) 432-5156
NPI assigned
Jan 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS036057 PA Primary

Addresses

Primary practice location

431 Haines Mill Rd
Allentown, PA 18104

Mailing address

431 Haines Mill Rd
Allentown, PA 18104
Phone (610) 432-1228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20160727000079 PA Order and Referring Only - DentistPractitioner - Dentist 0244523397

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS036057PAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1801946587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 HAINES MILL RD",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "18104",
            "telephone_number": "610-432-1228",
            "fax_number": "610-432-5156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 HAINES MILL RD",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "18104",
            "telephone_number": "610-432-1228",
            "fax_number": "610-432-5156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEY",
        "first_name": "JUSTIN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS036057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.