| Kdp Pllc | |
|
1212 N Kentucky St Kingston TN 37763-2328 | |
| (865) 717-3586 | |
| Not Available |
| Full Name | Kdp Pllc |
|---|---|
| Speciality | Dentist |
| Location | 1212 N Kentucky St, Kingston, Tennessee |
| Authorized Official Name and Position | Rajiv Bery (DENTIST) |
| Authorized Official Contact | 8034644448 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kdp Pllc 11600 Lanesborough Way Apt 116 Farragut TN 37934-1691 Ph: () - | Kdp Pllc 1212 N Kentucky St Kingston TN 37763-2328 Ph: (865) 717-3586 |
| NPI Number | 1699331421 |
|---|---|
| Provider Enumeration Date | 05/16/2019 |
| Last Update Date | 05/16/2019 |
| Medicare PECOS PAC ID | 2365810629 |
|---|---|
| Medicare Enrollment ID | O20221118000244 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699331421 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| Provider Name | Rajiv Bery |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1922592542 PECOS PAC ID: 9739431909 Enrollment ID: I20181016004092 |
| Provider Name | Kenneth Ryan Hale |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1447736186 PECOS PAC ID: 8325390487 Enrollment ID: I20221215002109 |
| Provider Name | Neil Alan Stebelton |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1881185908 PECOS PAC ID: 3072988476 Enrollment ID: I20230418000734 |
Kingston Dental Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1212 N Kentucky St, Kingston, TN 37763 Phone: 865-717-3586 Fax: 865-717-3581 | |
Mobile Unit 24 Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 820 N Kentucky St, Kingston, TN 37763 Phone: 865-804-2531 Fax: 865-966-1229 | |
Lakeview Dental Arts Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1011 Waterford Pl, Kingston, TN 37763 Phone: 865-376-9687 | |
Mobile 33 Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 820 N Kentucky St, Kingston, TN 37763 Phone: 865-804-2465 Fax: 865-966-1229 | |
Mobile 4 Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 820 N Kentucky St, Kingston, TN 37763 Phone: 865-804-2531 Fax: 865-966-1229 | |
Mobile 39 Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 820 N Kentucky St, Kingston, TN 37763 Phone: 865-804-2465 Fax: 865-966-1229 | |
Mobile Unit 22 Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 820 N Kentucky St, Kingston, TN 37763 Phone: 865-804-2465 Fax: 865-966-1229 |