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Deactivated NPI 1700953361 Deactivated / Inactive NPI Male Practitioner

Dr. John Theodore Kettlewell , DDS

Dentist - General Practice • Phoenix, AZ

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. John Kettlewell has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 29, 2006
NPI Deactivation Date April 10, 2025
Total Practice Duration ~19 Years of Practice (2006 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. John Kettlewell, DDS was a registered Dentist - General Practice practicing in Phoenix, AZ. Throughout an active medical career spanning 19 years, Dr. Kettlewell provided care at the practice location at 6226 N 27TH AVE until profile deactivation on 2025-04-10.

Practice Location & Contact Primary Location

Practice Address

6226 N 27th Ave

Phoenix, AZ 850176241

Telephone 6022422576
Fax 6022464225
Associated Practice Facility / Clinic
🏢 Desert Dentistry, Pllc Facility NPI 1306160791

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Phoenix, AZ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 26.2 Yrs
State Avg: 16.4 Yrs
Regional Practice Density
483 Specialists

Practicing in Phoenix, AZ (2600 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License AZ 1785

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
NPI 1043220486
NPI 1053152223

Doctor of Dental Medicine

Dr. Matthew Lonier , DDS

Dentist - General Practice

NPI 1689820144

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated April 10, 2025

Record deactivated on April 10, 2025

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 6226 N 27TH AVE, PHOENIX, AZ 850176241 (Tel: 6022422576)

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Updated Business Mailing Address July 08, 2007

Registered at 6226 N 27TH AVE, PHOENIX, AZ 850176241 (Tel: 6022422576)

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Provider Name / Credentials Updated July 08, 2007

Recorded as JOHN KETTLEWELL, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #1785 in AZ)

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Initial NPI Registration & Enumeration November 29, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1700953361
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 29, 2006
Last Update: July 08, 2007
Deactivation Date: April 10, 2025

Mailing Address

6226 N 27th Ave

Phoenix, AZ 850176241

Phone: 6022422576

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.