Individual provider Active NPI

Kirk Thomas Morris, DDS

  • Pediatric Dentistry
  • Kennewick, WA
National Provider Identifier
1053608331
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
60372817 Issued in WA
Practice address
2611 S Quillan PL
Kennewick, WA 99338-1899
Phone
(509) 585-5437
Fax
(509) 585-5438
NPI assigned
Jul 7, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Dentistry 1223P0221X 60372817 WA Primary

Addresses

Primary practice location

2611 S Quillan PL
Kennewick, WA 99338-1899

Mailing address

2611 S Quillan PL
Kennewick, WA 99338-1899
Phone (509) 585-5437

Other practice location 1

910 Madison Ave
Ste. 1031
Memphis, TN 38103-3403
Phone (901) 448-5364

Other practice location 2

39 Columbia Point Dr
Richland, WA 99352-4375
Phone (509) 946-9999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171128002706 WA Order and Referring Only - DentistPractitioner - Dentist 4385901412

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60372817WAMDPediatric Dentist

Interoperability endpoints

  • Direct secure messaging: kmorris18506@yvfwc.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1309996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1053608331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 S QUILLAN PL",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993381899",
            "telephone_number": "509-585-5437",
            "fax_number": "509-585-5438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 S QUILLAN PL",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993381899",
            "telephone_number": "509-585-5437",
            "fax_number": "509-585-5438"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "910 Madison Ave",
            "address_2": "Ste. 1031",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381033403",
            "country_code": "US",
            "telephone_number": "901-448-5364",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "39 Columbia Point Dr",
            "address_purpose": "LOCATION",
            "city": "Richland",
            "state": "WA",
            "postal_code": "993524375",
            "country_code": "US",
            "telephone_number": "509-946-9999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "KIRK",
        "middle_name": "THOMAS",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "60372817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

Verify at the official NPI Registry.