Shaun Christopher Kern, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5178 Issued in AL

Practice address

6593 Spanish Fort Blvd
Spanish Fort, AL 36527-5015

Phone

(251) 300-6100

Fax

(251) 300-6101

NPI assigned

Nov 8, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

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.

• Azalea City Dental LLC

  dba Azalea City Dental

  • General Practice Dentistry
  • Spanish Fort, AL
  • NPI 1275806770
  NPD (past)

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1811067168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6593 SPANISH FORT BLVD",
            "city": "SPANISH FORT",
            "state": "AL",
            "postal_code": "365275015",
            "telephone_number": "251-300-6100",
            "fax_number": "251-300-6101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6593 SPANISH FORT BLVD",
            "city": "SPANISH FORT",
            "state": "AL",
            "postal_code": "365275015",
            "telephone_number": "251-300-6100",
            "fax_number": "251-300-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERN",
        "first_name": "SHAUN",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "5178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly M Jones, D.M.D.
• Edward Lee Justice III
• Kayla Tibbs LLC
• Hannah Gabrielle Kazee
• Katheryn M Kennedy
• Matthew Kimbrell, DC
• John P Kline, PH.D.
• KMH Therapy Services
• Maggie Knight, MSN, CRNP, PMHNP-BC
• KRK Inc (Medicap Pharmacy)

• General Practice Dentistry in Spanish Fort, AL
• Providers in Spanish Fort, AL by specialty
• General Practice Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2020; 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.