Kate M Pennella, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

4628 Issued in SC

Practice address

5545 Platt Springs Rd
Lexington, SC 29073-7519

Phone

(919) 966-4834

Fax

(919) 966-1773

NPI assigned

Feb 2, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

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

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.

• White Knoll Dentistry, LLC

  • Dental Clinic/Center
  • Lexington, SC
  • NPI 1033341433
  NPD (past)

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

{
    "created_epoch": "1265068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323648000000",
    "number": "1831421890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5545 PLATT SPRINGS RD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290737519",
            "telephone_number": "803-359-3245",
            "fax_number": "803-359-0214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5545 PLATT SPRINGS RD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290737519",
            "telephone_number": "919-966-4834",
            "fax_number": "919-966-1773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNELLA",
        "first_name": "KATE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-02",
        "last_updated": "2011-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "4628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX4628",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shekena L Peeples
• David B Pelley, LPCA
• Lauren A Pellington, M. ED.
• Yoan Ivaylov Penev
• Daniel Ryan Pennella, D.M.D., M.S.D.
• Peoples Residential Care, LLC
• David Perez, PA
• Performance Medical Supply Inc.
• David Wayne Perrault, MED, LPC-I
• Robert S Perry, RPH

• Dentist in Lexington, SC
• Providers in Lexington, SC by specialty
• Dentist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; 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.