Individual provider Active NPI

Randa Zarka

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Lapeer, MI
National Provider Identifier
1073663241
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
2901600719 Issued in MI
Practice address
1057 Suncrest Dr Ste 3
Lapeer, MI 48446-4404
Phone
(810) 666-3300
Fax
(810) 666-3200
NPI assigned
Jan 11, 2007
Last updated
May 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 12012975A IN
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 2901600719 MI Primary

Addresses

Primary practice location

1057 Suncrest Dr Ste 3
Lapeer, MI 48446-4404

Mailing address

1057 Suncrest Dr Ste 3
Lapeer, MI 48446-4404
Phone (810) 666-3300

Other practice location 1

1852 Bluffton Rd
Fort Wayne, IN 46809-1306
Phone (260) 479-1086

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
12012975AINMDOrthodontics and Dentofacial Orthopedic Dentist
2901600719MIMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Kool Smiles in Ft. Wayne, PC General Practice Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rzarka@direct.westerndental.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1073663241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1057 SUNCREST DR STE 3",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484464404",
            "telephone_number": "810-666-3300",
            "fax_number": "810-666-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 SUNCREST DR STE 3",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484464404",
            "telephone_number": "810-666-3300",
            "fax_number": "810-666-3200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1852 Bluffton Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468091306",
            "country_code": "US",
            "telephone_number": "260-479-1086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZARKA",
        "first_name": "RANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IN",
            "license": "12012975A",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MI",
            "license": "2901600719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lapeer, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; 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.