Kenneth Eugene Perino, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

HD104742 Issued in CO

Practice address

2532 Patterson Road
Suite 10
Grand Junction, CO 81505-1098

Phone

(970) 241-2820

Fax

(970) 248-9553

NPI assigned

Oct 17, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267488000000",
    "number": "1871674069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2532 PATTERSON ROAD",
            "address_2": "SUITE 10",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815051098",
            "telephone_number": "970-241-2820",
            "fax_number": "970-248-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2532 PATTERSON ROAD",
            "address_2": "SUITE 10",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815051098",
            "telephone_number": "970-241-2820",
            "fax_number": "970-248-9553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERINO",
        "first_name": "KENNETH",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2010-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CO",
            "license": "HD104742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02047421",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Penkaty
• Angela M Pennell, M.D.
• Maylin Peppelman
• Shannon Renee Perez, LCSW
• Vanessa Perez, B.A.
• Natalie Marie Perkins, PH.D.
• Zachary Robert Perkins
• Steven Perry
• Reese Anders Pertile
• Paul R Pesantes

• Oral and Maxillofacial Surgery (Dentist) in Grand Junction, CO
• Providers in Grand Junction, CO by specialty
• Oral and Maxillofacial Surgery (Dentist) in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 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.