Jeffrey N. Kenney, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

6963 Issued in VA

Practice address

12420 Warwick Blvd
2-A
Newport News, VA 23606-3001

Phone

(757) 595-1457

NPI assigned

Jun 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

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2021 through Apr 1, 2027

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.

• Ronald Tankersley DDS Numa Ray Lee DDS Jeffrey N Kenney DDS W Les

  • Oral and Maxillofacial Surgery (Dentist)
  • Newport News, VA
  • NPI 1295930097
  NPD (past)
• TDT Oms

  • Oral and Maxillofacial Surgery (Dentist)
  • Newport News, VA
  • NPI 1831476886
  NPD (past)

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1831130400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12420 WARWICK BLVD STE 2A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236063046",
            "telephone_number": "757-595-1457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12420 WARWICK BLVD",
            "address_2": "2-A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236063001",
            "telephone_number": "757-595-1457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEY",
        "first_name": "JEFFREY",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "6963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "243305",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "556969",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL DENTAL",
            "identifier": "0009510",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8061114",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gamion Kelly, PHARMD
• Lynn C Kelly, PA
• Robert J. Kelly, MSW
• Anne Kennedy, NP
• Robinetta Kennedy
• Carol Kenreigh, ND, MH, CHS, CNC
• Jolynn Jennifer Kernan, PSY.D.
• Brent Robert Kerrick, PHARM D
• Charles Ronald Kersh, MD
• Connie Swartz Ketten, M.D.

• Oral and Maxillofacial Surgery (Dentist) in Newport News, VA
• Providers in Newport News, VA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.