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Deactivated NPI 1912114166 Deactivated / Inactive NPI Male Practitioner

Dr. Kenneth Michael Dubuque , DDS

Dentist - General Practice • Hamilton, OH

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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. Kenneth Dubuque has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 17, 2007
NPI Deactivation Date September 16, 2021
Total Practice Duration ~14 Years of Practice (2007 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. Kenneth Dubuque, DDS was a registered Dentist - General Practice practicing in Hamilton, OH. Throughout an active medical career spanning 14 years, Dr. Dubuque provided care at the practice location at 1 S EDGEWOOD DENTURE CLINIC until profile deactivation on 2021-09-16.

Practice Location & Contact Primary Location

Practice Address

1 S Edgewood Denture Clinic

Hamilton, OH 450132505

Telephone 5138689277
Associated Practice Facility / Clinic
🏢 Edgewood Dental Clinic Facility NPI 1194936724

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Hamilton, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 19.6 Yrs
Regional Practice Density
27 Specialists

Practicing in Hamilton, OH (4287 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 OH 11994

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.

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 September 16, 2021

Record deactivated on September 16, 2021

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 1 S EDGEWOOD DENTURE CLINIC, HAMILTON, OH 450132505 (Tel: 5138689277)

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Updated Business Mailing Address July 08, 2007

Registered at 5581 AUTUMN WYND LN, MILFORD, OH 451502777 (Tel: 5135766011)

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Provider Name / Credentials Updated July 08, 2007

Recorded as KENNETH DUBUQUE, DDS

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

Dentist (License #11994 in OH)

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Initial NPI Registration & Enumeration May 17, 2007

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: 1912114166
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 17, 2007
Last Update: July 08, 2007
Deactivation Date: September 16, 2021

Mailing Address

5581 Autumn Wynd Ln

Milford, OH 451502777

Phone: 5135766011

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.