KENNEDY DENTAL LLC NPI 1003065251

NPI Information

  • NPI: 1003065251
  • Provider Name: KENNEDY DENTAL LLC
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Address: 3506 N LOMBARD ST
    PORTLAND, OR
    ZIP 97217
  • Phone: (503) 289-0230

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NPI Details

KENNEDY DENTAL LLC is a general practice dentist in Portland, OR. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. KENNEDY DENTAL LLC NPI is 1003065251. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3506 N LOMBARD ST
PORTLAND, OR
ZIP 97217-902
Phone: (503) 289-0230
Fax: (503) 286-5055

The provider's authorized official is Gerald Kennedy .
The authorized official title is Owner/dentist and has the following contact phone number (503) 289-0230.

The enumeration date for this NPI number is 9/11/2008 and was last updated on 10/30/2024.

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
11223G0001XDentistGeneral PracticeD6716OREGONYes

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: 3/30/2025

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