Individual provider Active NPI

John B Kenison, DDS

  • General Practice Dentistry
  • Milford, NH
National Provider Identifier
1992917868
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1004 Issued in NH
Practice address
99 Amherst St
Milford, NH 03055-4017
Phone
(603) 673-1233
Fax
(603) 673-8116
NPI assigned
May 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1004 NH Primary

Addresses

Primary practice location

99 Amherst St
Milford, NH 03055-4017

Mailing address

99 Amherst St
Milford, NH 03055-4017
Phone (603) 673-1233

Other identifiers 1

IdentifierTypeStateIssuer
89191361MedicaidNH

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1004NHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
John B. Kenison, DDS, PA General Practice Past Accepting new patients
Souhegan Valley Dental Past 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": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992917868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 AMHERST ST",
            "city": "MILFORD",
            "state": "NH",
            "postal_code": "030554017",
            "telephone_number": "603-673-1233",
            "fax_number": "603-673-8116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 AMHERST ST",
            "city": "MILFORD",
            "state": "NH",
            "postal_code": "030554017",
            "telephone_number": "603-673-1233",
            "fax_number": "603-673-8116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENISON",
        "first_name": "JOHN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NH",
            "license": "1004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89191361",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.