O'Neill, Kevan

O'Neill, Kevan is an individual health care provider with primary practice located at 2 Dudley St Moc 180, Providence RI 02905-3236. He recently has 2 registered licenses in different health care specialties including Dental Providers / Orthodontics and Dentofacial Orthopedics, Dental Providers / Dentist. Dental Providers / Dentist is his primary health care specialty. O'Neill, Kevan can be contacted via phone (401) 444-2299.

Contact Information

Primary practice address
2 Dudley St Moc 180 Providence RI 02905-3236
Phone: (401) 444-2299
Fax: (401) 444-2924
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 056003 New York
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X DEN03205 Rhode Island
Dental Providers / Dentist 122300000X 30.024958 Ohio

Profile Details

NPI number 1528329372
LBN Legal business name O'Neill, Kevan
Credentials DDS, MDS
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2012
Last updated Oct 16th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528329372 NPPES
Ohio MEDICAID 0462064

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