Individual provider Active NPI

Robert L Kintz, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Grand Rapids, MI
National Provider Identifier
1003908575
Registry record updated Mar 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
RK015332 Issued in MI
Practice address
2144 E Paris Ave SE
Suite 150
Grand Rapids, MI 49546-6111
Phone
(616) 942-2000
Fax
(616) 942-6805
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X RK015332 MI Primary

Addresses

Primary practice location

2144 E Paris Ave SE
Suite 150
Grand Rapids, MI 49546-6111

Mailing address

6025 3 Mile Rd NE
Ada, MI 49301-9591
Phone (616) 682-1708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RK015332MIMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490227200000",
    "number": "1003908575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6025 3 MILE RD NE",
            "city": "ADA",
            "state": "MI",
            "postal_code": "493019591",
            "telephone_number": "616-682-1708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2144 E PARIS AVE SE",
            "address_2": "SUITE 150",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466111",
            "telephone_number": "616-942-2000",
            "fax_number": "616-942-6805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINTZ",
        "first_name": "ROBERT",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2017-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "RK015332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.