Jerry J Kirk, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901011909 Issued in MI

Practice address

25147 W Warren Ave
Dearborn Heights, MI 48127-2198

Phone

(313) 277-3000

Fax

(313) 277-3068

NPI assigned

Jan 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Salam Awad DDS PLLC

  • Dental Clinic/Center
  • Dearborn Heights, MI
  • NPI 1548763592
  NPD (past)

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073583324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25147 W WARREN AVE",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "48127",
            "telephone_number": "313-277-3000",
            "fax_number": "313-277-3068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25147 W WARREN AVE",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481272198",
            "telephone_number": "313-277-3000",
            "fax_number": "313-277-3068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "JERRY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901011909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Radwan Khazaal, D.C.
• Ali Khcheiche, DDS
• Maya Khreizat, DMD
• Kid Kare Pediatrics, PC
• Kim Yu MD PC
• Kirsch & Blau DDS PC
• Mariam Kobeissi
• Lara Haytham Kochak
• Amy Kodrik, D.O.
• Steven D Kohl, DO

• General Practice Dentistry in Dearborn Heights, MI
• Providers in Dearborn Heights, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.