Rajiv Bery, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

10812 Issued in TN

Practice address

1212 N Kentucky St
Kingston, TN 37763-2328

Phone

(865) 717-3586

NPI assigned

Jun 18, 2018

Last updated

Jun 18, 2018By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in TN

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

Practice roles

Locations

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.

• KDP PLLC

  • General Practice Dentistry
  • Kingston, TN
  • NPI 1699331421
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529280000000",
    "number": "1922592542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 WALTERS AVE",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370672604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 N KENTUCKY ST",
            "city": "KINGSTON",
            "state": "TN",
            "postal_code": "377632328",
            "telephone_number": "865-717-3586"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "119 Walters Ave",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "TN",
            "postal_code": "370672604",
            "country_code": "US",
            "telephone_number": "803-464-4448",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERY",
        "first_name": "RAJIV",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-18",
        "last_updated": "2018-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "10812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Jay Baggett, PHARM.D
• Floyd Joseph Bassler, PT
• Janel Danos Bell, OTR L
• Kimberly C Bell, NP-C
• Timothy Edward Bell, D.O.
• Thomas Francis Boduch, M.D.
• Rhonda Lee Bonfini, DPH
• Andrea Marie Branson, PT
• Cynthia Branson
• Rosza Branson

• Dentist in Kingston, TN
• Providers in Kingston, TN by specialty
• Dentist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2018; 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.