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Deactivated NPI 1093739856 Deactivated / Inactive NPI Male Practitioner

Dr. Kenneth Dewayne Short , DDS

Dentist - General Practice • Boyd, TX

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

Registration / Start Date July 26, 2006
NPI Deactivation Date May 13, 2019
Total Practice Duration ~13 Years of Practice (2006 – 2019)

Professional Overview & Biography Verified Profile Summary

Dr. Kenneth Short, DDS was a registered Dentist - General Practice practicing in Boyd, TX. Throughout an active medical career spanning 13 years, Dr. Short provided care at the practice location at 412 WEST ROCK ISLAND until profile deactivation on 2019-05-13.

Practice Location & Contact Primary Location

Practice Address

412 West Rock Island

Boyd, TX 760233104

Telephone 9404338545
Fax 9404330155
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Boyd, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 12.3 Yrs
Regional Practice Density
2 Specialists

Practicing in Boyd, TX (10570 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 TX 14693

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 May 13, 2019

Record deactivated on May 13, 2019

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 412 WEST ROCK ISLAND, BOYD, TX 760233104 (Tel: 9404338545)

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Updated Business Mailing Address July 08, 2007

Registered at PO BOX 319, BOYD, TX 760230319 (Tel: 9404338545)

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Provider Name / Credentials Updated July 08, 2007

Recorded as KENNETH SHORT, D.D.S.

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

Dentist (License #14693 in TX)

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Initial NPI Registration & Enumeration July 26, 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: 1093739856
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 26, 2006
Last Update: July 08, 2007
Deactivation Date: May 13, 2019

Mailing Address

Po Box 319

Boyd, TX 760230319

Phone: 9404338545

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.