Patrick Kennedy, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019028103 Issued in IL

Practice address

3312 Hudson Ave Apt 7J
Union City, NJ 07087-5967

Phone

(917) 420-0496

NPI assigned

Jun 15, 2010

Sex

Male

Sole proprietor

No

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 IL

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

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

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277856000000",
    "number": "1831410653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3312 HUDSON AVE APT 7J",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070875967",
            "telephone_number": "917-420-0496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3312 HUDSON AVE APT 7J",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070875967",
            "telephone_number": "917-420-0496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-15",
        "last_updated": "2010-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019028103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kearny Pharmacy Inc
• Kells Dental
• Kennedy Dental Center PA
• Kennedy Wellness Center Corp
• Josephine Kathryn Kennedy, OTR
• Ani Keshishyan
• Khawajarx
• Khovision LLC
• Kids Dental of Union City PC
• Elizabeth Jeeyun Kim, DMD, MS

• General Practice Dentistry in Union City, NJ
• Providers in Union City, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2010; 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.