Mark Alan Kirk, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3137WV Issued in WV

Practice address

308 East Main St
White Sulphur Springs, WV 24986

Phone

(304) 536-1721

Fax

(304) 536-1561

NPI assigned

Nov 29, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114094927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 EAST MAIN ST",
            "city": "WHITE SULPHUR SPRINGS",
            "state": "WV",
            "postal_code": "24986",
            "telephone_number": "304-536-1721",
            "fax_number": "304-536-1561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 EAST MAIN ST",
            "city": "WHITE SULPHUR SPRINGS",
            "state": "WV",
            "postal_code": "24986",
            "telephone_number": "304-536-1721",
            "fax_number": "304-536-1561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "3137WV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0133809000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Kathleen Jakubow
• Douglas L Jones, MD
• Lula Keatley
• Michaela Keatley, MS CCC-SLP
• Vanessa Kelley
• Richard B Kline, MD
• Kimberly Lewis
• Abraham Charles Lilly, DDS
• Joseph David Lippoli, PTA
• Chelsey Loudermilk

• General Practice Dentistry in White Sulphur Springs, WV
• Providers in White Sulphur Springs, WV by specialty
• General Practice Dentistry in West Virginia

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.