Paul Kenworthy DMD PC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

975 Issued in VT

Legal business name

PAUL KENWORTHY DMD PC

Practice address

1 Place Notre Dame
St Johnsbury, VT 05819-2223

Phone

(802) 879-5151

Fax

(866) 561-8426

NPI assigned

May 6, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Paul Kenworthy, DMD

Title

Owner/Dentist

Phone

(802) 879-5151

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1430870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445817600000",
    "number": "1871970145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 KELLOGG RD",
            "city": "ESSEX JUNCTION",
            "state": "VT",
            "postal_code": "054522815",
            "telephone_number": "802-879-5151",
            "fax_number": "866-561-8426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PLACE NOTRE DAME",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "058192223",
            "telephone_number": "802-879-5151",
            "fax_number": "866-561-8426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL KENWORTHY DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-06",
        "last_updated": "2015-10-26",
        "status": "A",
        "authorized_official_last_name": "KENWORTHY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "802-879-5151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "VT",
            "license": "975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2551",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carey Elizabeth Page, R.D.
• Jason Ryan Parks, M.D.
• Karyn Marie Patno, MD
• Richelle Monte de Ramos Patron
• Janet L Patterson, N.P.
• Elaine Paul, M.D.
• Alexandra Perreault, APRN
• Denise Laferriere Perry
• Tamara A Peters, C.M.T
• Stephen J Phipps, M.D.

• Customized Equipment (DME) in St Johnsbury, VT
• Providers in St Johnsbury, VT by specialty
• Customized Equipment (DME) in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2015; 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.