Provider Demographics
NPI:1194005454
Name:R. KEVIN AIKEN D.D.S., P.A.
Entity Type:Organization
Organization Name:R. KEVIN AIKEN D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:AIKEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, PA
Authorized Official - Phone:910-895-5210
Mailing Address - Street 1:715 LONG DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28379-4315
Mailing Address - Country:US
Mailing Address - Phone:910-895-5210
Mailing Address - Fax:910-895-4602
Practice Address - Street 1:715 LONG DRIVE
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-4315
Practice Address - Country:US
Practice Address - Phone:910-895-5210
Practice Address - Fax:910-895-4602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-18
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC66191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8902450Medicaid