JENNIFER A KENNEDY DDS LLC NPI 1992136345

NPI Information

NPI: 1992136345
Provider Name: JENNIFER A KENNEDY DDS LLC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
601 BROADWAY AVE
MATTOON, IL
ZIP 61938
Phone: (217) 235-0556
Get Directions

JENNIFER A KENNEDY DDS LLC is a dental clinic center in Mattoon, IL. JENNIFER A KENNEDY DDS LLC NPI is 1992136345. The provider is registered as an organization entity type.

The provider's business location address is:

601 BROADWAY AVE
MATTOON, IL
ZIP 61938-340
Phone: (217) 235-0556
Fax: (217) 234-7243

The provider's authorized official is Jennifer A Kennedy .
The authorized official title is Dentist and has the following contact phone number (217) 235-0556.

The enumeration date for this NPI number is 12/11/2013 and was last updated on 12/11/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental	019024517	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »