Kevin C. Dean, D.M.D

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN0012675 Issued in FL

Practice address

4850 N 9TH Ave Ste 4
Pensacola, FL 32503-2406

Phone

(850) 477-1125

Fax

(850) 479-5809

NPI assigned

Jul 13, 2006

Last updated

Nov 15, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 1, 2021 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kevin C. Dean, DMD PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Pensacola, FL
  • NPI 1528345840
  NPD (past)
• Hospital Service District No. 2

  • Critical Access Hospital
  • Breaux Bridge, LA
  • NPI 1548263262
  NPD (past)

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321315200000",
    "number": "1922023563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 N 9TH AVE STE 4",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032406",
            "telephone_number": "850-477-1125",
            "fax_number": "850-479-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 N 9TH AVE STE 4",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032406",
            "telephone_number": "850-477-1125",
            "fax_number": "850-479-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN",
        "first_name": "KEVIN",
        "middle_name": "C.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2011-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN0012675",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AL",
            "license": "4835",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "071631600",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009973460",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Darcy Rochelle Dean, LICSW
• David Dean, ED.D.
• Dominique Dean
• Heather Dean, ARNP-C
• Joshua Steven Dean, FNP-C
• Philip C Dean, MD
• Ward Dean, M.D.
• Courtney Deason, DPT
• Julie Debarba
• Debbie Clark Support Services Inc.

• Oral and Maxillofacial Surgery (Dentist) in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.