Dr. Kenneth Palm

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

01237 Issued in VT

Legal business name

DR. KENNETH PALM

Practice address

106 High Point Ctr
Suite 100
Colchester, VT 05446-5861

Phone

(802) 655-5308

Fax

(802) 655-5715

NPI assigned

May 9, 2007

Organization subpart

No

Name

Dr. Kenneth Palm, D.D.S.NPI 1184746851

Title

Dentist

Phone

(802) 655-5308

Organizations that report the same tax identification number in the National Provider Directory.

• Colchester Dental Group

  • Dentist
  • Colchester, VT
  • NPI 1255734893
  NPD tax ID

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth Palm, D.M.D.

  • General Practice Dentistry
  • Colchester, VT
  • NPI 1184746851

  General Practice

  NPD (past) Authorized official

Tax ID family

Colchester Dental Group (2 organizations share this tax ID)

Locations

• Colchester Dental Group Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 17, 2008.

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216252800000",
    "number": "1871707786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 HIGH POINT CTR",
            "address_2": "SUITE 100",
            "city": "COLCHESTER",
            "state": "VT",
            "postal_code": "054465861",
            "telephone_number": "802-655-5308",
            "fax_number": "802-655-5715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 HIGH POINT CTR",
            "address_2": "SUITE 100",
            "city": "COLCHESTER",
            "state": "VT",
            "postal_code": "054465861",
            "telephone_number": "802-655-5308",
            "fax_number": "802-655-5715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. KENNETH PALM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2008-07-17",
        "status": "A",
        "authorized_official_last_name": "PALM",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "802-655-5308",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "VT",
            "license": "01237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1005081",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE DENTAL LICENSE",
            "identifier": "01237",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colchester Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kayla June Disciullo, PTA
• Sarah Doben, PT, DPT
• Jillian Leigh Donovan, PHARMD
• Priscilla Douglas, M.S.
• Dr Anna M Bolanis Family Dentistry Inc
• Thomas Peter Drougas, RPH
• Owen W Drudge, PH.D.
• Megan Dunston, LCMHC
• John M Dupont, COTA
• Christine Sandra Dutil, RPH

• All providers in Colchester, VT
• General Practice Dentistry in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.