Noel P Kornett, DDS

Individual provider Active NPI General Practice Dentistry · Stuart, VA

NPI 1962402610 · NPPES record last updated Jul 13, 2026

Key facts

NPI
1962402610
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
0401005793 (VA)
Practice address
113 W Blue Ridge St
Stuart, VA 24171-1577
Phone
(276) 694-3371
Fax
(276) 694-3930
NPI assigned
Jul 22, 2005
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160405000628 VA Order and Referring Only - Dentist
Practitioner - Dentist
8325345473

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
0401005793VAMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401005793 VA Yes

Addresses

Primary practice location

113 W Blue Ridge St
Stuart, VA 24171-1577

Mailing address

113 W Blue Ridge St
PO Box 312
Stuart, VA 24171-1577
Phone (276) 694-3371

Other providers in Stuart, VA

All providers in Stuart, VA · General Practice Dentistry in Virginia

Sources for this page

Verify at the official NPI Registry.