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DR. KENNETH MACCORMAC II DMD
NPI 1669057113
Student in an Organized Health Care Education/Training Program in Farmington, CT

Active since March 16, 2021PECOS Enrolled
273 FARMINGTON AVENUE, FARMINGTON, CT 06030(860) 679-2000 Get Directions Write a Review

NPPES record last updated: June 3, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 3, 2021, Mar 16, 2021 (2 updates tracked since 2021).

About Dr. Kenneth Maccormac Ii Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KENNETH MACCORMAC II DMD (NPI 1669057113) is an individual student in an organized health care education/training program in Farmington, Connecticut, licensed in Connecticut (13101) and active in the NPI registry since March 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1669057113
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. KENNETH MACCORMAC IICredential: DMD
Location Address273 FARMINGTON AVENUEFarmington, CT 06030-0001
Mailing Address26 Lincoln LnWeatogue, CT 06089-9780 · (860) 716-2702
Phone(860) 679-2000
Sole ProprietorNo
Enumeration DateMarch 16, 2021
Last NPPES UpdateJune 3, 20212 updates tracked since enumeration
NPPES CertifiedJune 3, 2021
✔ NPI 1669057113 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in CT · 13101
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
273 FARMINGTON AVENUE, Farmington, CT 06030
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kenneth Maccormac Ii Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth Maccormac's NPI number?

The NPI number for Kenneth Maccormac is 1669057113. It was assigned to this individual provider in the NPPES registry on March 16, 2021.

Where is Kenneth Maccormac located?

Kenneth Maccormac practices at 273 Farmington Avenue, Farmington, CT 06030. The listed phone number is (860) 679-2000.

What is Kenneth Maccormac's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Kenneth Maccormac enrolled in Medicare?

Yes. Kenneth Maccormac is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kenneth Maccormac was last updated on June 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.