Active NPI
Phillip Thomas Doyle, DDS MS
- Periodontics
- Kalamazoo, MI
National Provider Identifier
1053483826
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- PD009409
- Practice address
- 1850 Whites Rd
Kalamazoo, MI 49008 - Phone
- (269) 381-3212
- Fax
- (269) 381-7846
- NPI assigned
- Nov 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | PD009409 | MI | Primary |
Addresses
Primary practice location
1850 Whites Rd
Kalamazoo, MI 49008
Mailing address
1850 Whites Rd
Kalamazoo, MI 49008
Phone (269) 381-3212
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PD009409 | MI | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1053483826",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1850 WHITES RD",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "49008",
"telephone_number": "269-381-3212",
"fax_number": "269-381-7846"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1850 WHITES RD",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "49008",
"telephone_number": "269-381-3212",
"fax_number": "269-381-7846"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOYLE",
"first_name": "PHILLIP",
"middle_name": "THOMAS",
"credential": "DDS MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-15",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "MI",
"license": "PD009409",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kalamazoo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.