DR. KENNETH DWAYNE LEWIS (NPI# 1871505529) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871505529 |
| Entity Type | Individual |
| Full Name | DR. KENNETH DWAYNE LEWIS |
| Credential | DDS |
| Practice Address |
1149 E 42nd St Odessa TX 79762-7723 |
| Practice Telephone | 4323627927 |
| Practice Fax Number | 4323627928 |
| Mailing Telephone | 4323627927 |
| Mailing Fax Number | 4323627928 |
| Enumeration Date | 2006-08-12 |
| 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 |
15924 | TX | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS | D15924 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467064832 | Kenneth Robert Lewis | Peer Specialist | 320 N Goodman St Ste 202320, Rochester, NY 14607-1185 | 2020-08-18 |
| 1306311840 | Kenneth Paul Lewis | Massage Therapist | 3220 17th St Nw # 10, Washington, DC 20010-2135 | 2018-10-11 |
| 1881123305 | Kenneth Boyd Lewis Jr. | Dentist | 4140 Ramsey St Ste 104, Fayetteville, NC 28311-7658 | 2017-06-08 |
| 1154709350 | Kenneth Lewis | Counselor | 4323 142nd Pl Se, Snohomish, WA 98296-7646 | 2015-05-08 |
| 1629204649 | Kenneth Robert Lewis | Case Manager/Care Coordinator | 9412 W 5th Pl, Kennewick, WA 99336-9603 | 2009-06-04 |
| 1023097870 | Kenneth B Lewis | Dentist | 4140 Ramsey St, Fayetteville, NC 28311-7658 | 2006-01-11 |
| 1285299081 | Kenneth Lewis | Case Manager/Care Coordinator | 10001 Lake Forest Blvd Ste 607, New Orleans, LA 70127-6201 | 2019-05-07 |
| 1578028486 | Kenneth Lewis | Licensed Practical Nurse | 27777 Inkster Rd, Farmington Hills, MI 48334-5326 | 2019-02-05 |
| 1952751315 | Kenneth Bryant Lewis | General Practice | 1638 Owen Dr, Fayetteville, NC 28304-3424 | 2016-06-16 |
| 1841660693 | Kenneth Lewis | Counselor | 931 Westwood Dr, Suite E, Marrero, LA 70072-2400 | 2015-10-05 |
| Street Address |
1149 E 42ND ST |
| City | ODESSA |
| State | TX |
| Zip Code | 79762-7723 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982256798 | Winwood Dental and Orthodontics Pllc | Dentist | 3913 E 42nd Street, Odessa, TX 79762 | 2019-07-11 |
| 1265995716 | Ryan Daniels | Specialist/Technologist | 4901 E University, Gym 111, Odessa, TX 79762 | 2019-04-11 |
| 1215429592 | Michael Wayne Samp | Respiratory Therapist, Registered | 2807 Windsor Dr, Odessa, TX 79762 | 2018-06-03 |
| 1972003663 | Kristi Young | Registered Nurse | 3800 E. 42nd St., Suite 203 Attn: Pediatric Dept, Odessa, TX 79762 | 2018-02-19 |
| 1427508902 | Whitney Diakur | Optometrist | 5011 E. 42nd St, Odessa, TX 79762 | 2016-10-10 |
| 1295184927 | Farqad Kamal Abuoudeh | Dentist | 6109 Tx-191 Frontage, Odessa, TX 79762 | 2016-06-03 |
| 1457714180 | Daniel & Max, LLC | Optometrist | 5011 E. 42nd Street, Odessa, TX 79762 | 2016-03-31 |
| 1407225774 | Neri Campos-gardea | Massage Therapist | 3952 E 42d, Odessa, TX 79762 | 2015-09-17 |
| 1508255886 | Permian Er IIi | Clinic/Center | 6131 East Highway 191, Odessa, TX 79762 | 2015-01-09 |
| 1548675861 | Tina Desai | Dentist | 6109 Texas 191, Odessa, TX 79762 | 2014-06-25 |
| Find all providers in zip 79762 | ||||
| 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 |
|---|---|---|---|---|
| 1427619238 | Benjamin Bennett Waites | Dentist | 4901 E 42nd St Ste B, Odessa, TX 79762-7338 | 2019-06-23 |
| 1619443736 | Abbeville Dentistry - Odessa East, Pllc | Dentist | 2499 E 11th St, Odessa, TX 79761-4232 | 2018-10-16 |
| 1124535885 | Anisha Patel | Dentist | 6909 Arabian Rd, Odessa, FL 33556-1825 | 2018-01-03 |
| 1346759487 | Andes Dental Pllc | Dentist | 1157 E 42nd St Ste A, Odessa, TX 79762-7723 | 2017-09-20 |
| 1629592217 | Quyen Tran | Dentist | 2260 Linda Ave Ste 103, Odessa, TX 79763-2665 | 2017-07-26 |
| 1861920886 | Constance Schreck | Dentist | 2631 Faudree Rd Ste B, Odessa, TX 79765-8530 | 2017-06-03 |
| 1295184927 | Farqad Kamal Abuoudeh | Dentist | 6109 Tx-191 Frontage, Odessa, TX 79762 | 2016-06-03 |
| 1285011882 | Precious Smiles Dentistry, PC | Dentist | 2713 N Grandview Ave, Odessa, TX 79762-6952 | 2015-05-04 |
| 1821494121 | Robert Meek | Dentist | 7331 Eastridge Rd, Odessa, TX 79765-8903 | 2014-11-13 |
| 1548675861 | Tina Desai | Dentist | 6109 Texas 191, Odessa, TX 79762 | 2014-06-25 |
| Find all providers in ODESSA | ||||
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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.