Active NPI
Kirk William Noraian, D.D.S.
- Periodontics
- Bloomington, IL
National Provider Identifier
1023138120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- Practice address
- 105 N Williamsburg Dr
Bloomington, IL 61704-3528 - Phone
- (309) 663-4577
- Fax
- (306) 663-2854
- NPI assigned
- Mar 30, 2007
- Last updated
- Sep 11, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | IL | ||
| Periodontics | 1223P0300X | IL | Primary |
Addresses
Primary practice location
105 N Williamsburg Dr
Bloomington, IL 61704-3528
Mailing address
105 N Williamsburg Dr
Bloomington, IL 61704-3528
Phone (309) 663-4577
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150623001569 | IL | Order and Referring Only - Oral Surgery | 9436460078 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019-021623 | IL | MD | Dentist |
| 021-001562 | IL | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gibson Community Hospital Association | Past | Accepting new patients | |
| Kirk W. Noraian, D.D.S., M.S., P.C. | Dentist | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Periodontics
- Urbana, IL
- NPI 1467574368
-
dba Gibson Area Hospital and Health Services
- Critical Access Hospital
- Gibson City, IL
- NPI 1114935681
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1023138120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 N WILLIAMSBURG DR",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617043528",
"telephone_number": "309-663-4577",
"fax_number": "306-663-2854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 N WILLIAMSBURG DR",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617043528",
"telephone_number": "309-663-4577",
"fax_number": "306-663-2854"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORAIAN",
"first_name": "KIRK",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-30",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": null,
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bloomington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.