Active NPI
Kevin Clark Utley, D.D.S.,M.S
- Orthodontics and Dentofacial Orthopedics Dentistry
- Cordova, TN
National Provider Identifier
1972662005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DS5251
- Practice address
- 298 Germantown Bend CV
Cordova, TN 38018-7237 - Phone
- (901) 756-6200
- Fax
- (901) 756-5161
- NPI assigned
- Dec 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DS5251 | TN | Primary |
Addresses
Primary practice location
298 Germantown Bend CV
Cordova, TN 38018-7237
Mailing address
298 Germantown Bend CV
Cordova, TN 38018-7237
Phone (901) 756-6200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS5251 | TN | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1972662005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "298 GERMANTOWN BEND CV",
"city": "CORDOVA",
"state": "TN",
"postal_code": "380187237",
"telephone_number": "901-756-6200",
"fax_number": "901-756-5161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "298 GERMANTOWN BEND CV",
"city": "CORDOVA",
"state": "TN",
"postal_code": "380187237",
"telephone_number": "901-756-6200",
"fax_number": "901-756-5161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UTLEY",
"first_name": "KEVIN",
"middle_name": "CLARK",
"name_prefix": "Dr.",
"credential": "D.D.S.,M.S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-06",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "TN",
"license": "DS5251",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cordova, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.