Individual provider Active NPI

Kenneth E Myers, D.D.S.

  • General Practice Dentistry
  • Falmouth, ME
National Provider Identifier
1942390034
Registry record updated Apr 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3196 Issued in ME
Practice address
2 Blackstrap Rd
Falmouth, ME 04105-2238
Phone
(207) 797-3130
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3196 ME Primary

Addresses

Primary practice location

2 Blackstrap Rd
Falmouth, ME 04105-2238

Mailing address

2 Blackstrap Rd
Falmouth, ME 04105-2238
Phone (207) 797-3130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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

Enrollment IDStateProvider typePAC IDDetails
I20150804004935 ME Order and Referring Only - DentistPractitioner - Dentist 1456665413

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3196MEMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Kenneth E Myers D.D.S, PA General Practice Past Accepting new patients
Kelsey a Harney DMD LLC PastSince Nov 24, 2024 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428969600000",
    "number": "1942390034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 BLACKSTRAP RD",
            "city": "FALMOUTH",
            "state": "ME",
            "postal_code": "041052238",
            "telephone_number": "207-797-3130",
            "fax_number": "207-797-5580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 BLACKSTRAP RD",
            "city": "FALMOUTH",
            "state": "ME",
            "postal_code": "041052238",
            "telephone_number": "207-797-3130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "KENNETH",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2015-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ME",
            "license": "3196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Falmouth, ME

Sources for this page

Verify at the official NPI Registry.