DR. KENNETH WAYNE ROBERTS (NPI# 1124245006) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124245006 |
| Entity Type | Individual |
| Full Name | DR. KENNETH WAYNE ROBERTS |
| Credential | D.D.S. |
| Practice Address |
546 N Lafayette St South Lyon MI 48178-2000 |
| Practice Telephone | 2484861730 |
| Practice Fax Number | 2484869544 |
| Mailing Telephone | 2484861730 |
| Mailing Fax Number | 2484869544 |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
2901013871 | MI | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124678578 | Kenneth Andre Roberts II | Dietitian, Registered | 110 Mascoutah Ave, Belleville, IL 62220-3801 | 2019-09-18 |
| 1801359559 | Kenneth Wayne Roberts | Student in an Organized Health Care Education/Training Program | Aventura Hospital & Medical Center, 20900 Biscayne Blvd, Aventura, FL 33138 | 2019-04-10 |
| 1801157805 | Kenneth James Roberts Jr. | Massage Therapist | 9420 Towne Square Ave, Suite #3, Blue Ash, OH 45242-6922 | 2012-06-06 |
| 1194890848 | Kenneth C Roberts | Internal Medicine | 400 Veterans, Biloxy, MS 39531 | 2006-11-21 |
| 1598732521 | Kenneth E. Roberts | Family Medicine | 287 Healthwest Dr, Dothan, AL 36303-2031 | 2006-03-08 |
| 1285991620 | Kenneth Latroye Roberts | Counselor | 3435 W Shaw Ave, Ste. 101, Fresno, CA 93711-3234 | 2012-04-23 |
| 1740503556 | Kenneth Lewis Roberts | Counselor | 366 Prior Ave N, Saint Paul, MN 55104-5165 | 2010-03-08 |
| 1740329028 | Kenneth Eugene Roberts | Social Worker | 620 5th Avenue, Fairbanks, AK 99701 | 2007-02-05 |
| 1285748954 | Kenneth M. Roberts | Physician Assistant | 300 Clyde Morris Blvd, Suite C, Ormond Beach, FL 32174-5956 | 2006-08-18 |
| 1144264946 | Kenneth Barry Roberts | Pediatrics | 1200 N Elm St, Greensboro, NC 27401-1004 | 2006-06-15 |
| Street Address |
546 N LAFAYETTE ST |
| City | SOUTH LYON |
| State | MI |
| Zip Code | 48178-2000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245712199 | Natasha Gates Dds, Pllc | Clinic/Center | 546 N Lafayette St, South Lyon, MI 48178-2000 | 2018-09-06 |
| 1326592312 | Kenneth W Roberts, Dds, PC | Dentist | 546 N Lafayette St, South Lyon, MI 48178-2000 | 2016-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083231815 | Bhoomi Shah | Pharmacist | 22318 Pontiac Trail, South Lyon, MI 48178 | 2020-06-27 |
| 1649811845 | Center for Emdr and Trauma Therapy | Counselor | 28900 Pontiac Trail, South Lyon, MI 48178 | 2019-09-30 |
| 1295223386 | Cathrine Michelle Arneson | Massage Therapist | 321 Pettibone St. #101a, South Lyon, MI 48178 | 2018-04-25 |
| 1033592936 | 4-serv Family Medicine P.C. | Family Medicine | 51619 Ten Mile Rd, South Lyon, MI 48178 | 2015-07-09 |
| 1003299777 | James Sullivan | Physical Therapy Assistant | 10821 Bouldercrest Drive, South Lyon, MI 48178 | 2015-06-30 |
| 1255722088 | Jennifer Nidetz | Social Worker | 23015 Cheyenne Dr, South Lyon, MI 48178 | 2015-02-16 |
| 1174938658 | Michael Samir Matar | Family Medicine | 210 N Lafayette Street, South Lyon, MI 48178 | 2014-06-24 |
| 1043633191 | Kwonsoo Kenneth Kim | Anesthesiology | 8854 Stoney Creek Dr., South Lyon, MI 48178 | 2014-01-27 |
| 1285071860 | Ajanthan Sivagurunathan | Student in an Organized Health Care Education/Training Program | 210 North Lafayette, Providence Medical Center - South Lyon, South Lyon, MI 48178 | 2013-05-23 |
| 1184890055 | Yvonne Marie Snyder | Dentist | 100 E Lake St, South Lyon, MI 48178 | 2008-05-01 |
| Find all providers in zip 48178 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770757700 | Paul L Simon | Dentist | 21800 Pontiac Trail Ste 100, South Lyon, MI 48178 | 2008-04-22 |
| 1356568174 | Monica Dunbar | Dentist | 314 N Lafayette St, South Lyon, MI 48178-1253 | 2007-04-20 |
| 1497883532 | Paul L Simon Dds Plc | Dentist | 21800 Pontiac Trail, Ste 100, South Lyon, MI 48178 | 2007-03-01 |
| 1720125818 | Robert Borowiec | Dentist | 201 S Lafayette St, South Lyon, MI 48178-1405 | 2007-01-30 |
| 1679635932 | Sunrise Dental Associates | Dentist | 314 N Lafayette, South Lyon, MI 48178 | 2006-12-14 |
| 1801965603 | Samuel Edward Allen | Dentist | 7505 Tower Rd, South Lyon, MI 48178-7051 | 2006-11-07 |
| 1740248749 | Landi A Heller Dds | Dentist | 505 S Lafayette, South Lyon, MI 48178 | 2006-05-02 |
| 1598739153 | Michelle Conforti | Dentist | 25660 Pontiac Trl, South Lyon, MI 48178-9234 | 2006-02-13 |
| 1295728822 | David A. Farlow, Dds, PC | Dentist | 204 Whipple St, South Lyon, MI 48178-1114 | 2005-08-30 |
| 1619327673 | William Ryan Jenkins | Dentist | 110 E Lake St, South Lyon, MI 48178-1409 | 2016-06-20 |
| Find all providers in SOUTH LYON | ||||
| City | SOUTH LYON |
| Zip Code | 48178 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.