Kenneth F. Wallace

Primary specialty

DentistTaxonomy code 122300000X

License

6386 Issued in KY

Legal business name

KENNETH F. WALLACE

Practice address

280 Mount Zion Rd
Suite D
Florence, KY 41042-3217

Phone

(859) 283-1986

Fax

(859) 283-2586

NPI assigned

Jun 10, 2008

Last updated

Jun 10, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Franklin Wallace, DMDNPI 1942342548

Title

Dentist

Phone

(859) 283-1986

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth F Wallace, DMD

  • Dentist
  • Florence, KY
  • NPI 1942342548
  NPD (past) Authorized official

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213056000000",
    "number": "1952561375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 MOUNT ZION RD",
            "address_2": "SUITE D",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410423217",
            "telephone_number": "859-283-1986",
            "fax_number": "859-283-2586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 MOUNT ZION RD",
            "address_2": "SUITE D",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410423217",
            "telephone_number": "859-283-1986",
            "fax_number": "859-283-2586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH F. WALLACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-10",
        "last_updated": "2008-06-10",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "FRANKLIN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "859-283-1986",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "6386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60063864",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam Kelsey, LMT
• Kristin Dietz Kennedy, ARNP
• Wendy Kennedy
• Charles Edwin Kenner, D.M.D
• Katherine Elizabeth Kenner, BCBA
• Laura Cancilla Kenny, M.D.
• Kentucky CVS Pharmacy LLC (CVS Pharmacy #16557)
• Kentucky CVS Pharmacy, L.L.C. (CVS Pharmacy# 07648)
• Kentucky Easter Seal Society Inc (Cardinal Hill of Northern Kentucky)
• Claire Victoria Keyes, FNP

• Dentist in Florence, KY
• Providers in Florence, KY by specialty
• Dentist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.