Kevin M Kenny | San Diego, CA • PECOS Search

Kevin M Kenny

Dentist

Dental Providers

2619 Clairemont Dr, San Diego, CA 92117

PECOS Enrollment

Based on the most recent information from CMS, provider Kevin M Kenny does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1457477705
Provider Type
Individual
Full Name
Kenny, Kevin M
Title
Dr.
Credential
DDS

Gender
Male
Sole Proprietor
No
Enumeration Date
3/21/2007
Last Updated
7/8/2007

Contact Information

Practice Location

2619 Clairemont Dr, San Diego, CA 92117

(619) 276-0452

Mailing Location

2619 Clairemont Dr, San Diego, CA 92117

(619) 276-0452

Provider Taxonomies

Code	Description	License
Code 122300000X Primary	Description Dentist Dental Providers	License 33943 California