Individual
TIMOTHY RYAN KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1667 COCHRANE CIR BLDG 7495, FORT CARSON, CO 80913-4603
(719) 526-5537
Mailing address
3740 SOUTH 14TH ST, JOINT BASE LEWIS-MCCHORD, WA 98433
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10759
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10759
DENTAL LICENSE
KY
Enumeration date
07/08/2022
Last updated
08/25/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us