NPIMap

Organization Active NPI

Kenneth J. Kieft DDS PC

Doing business as Red Arrow Dentistry

  • General Practice Dentistry
  • Bridgman, MI
National Provider Identifier
1124293048
Registry record updated Apr 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901009243 Issued in MI
Legal business name
KENNETH J. KIEFT DDS PC
Doing business as
Red Arrow Dentistry
Practice address
9500 Red Arrow Hwy
Bridgman, MI 49106-9593
Phone
(269) 465-3001
Fax
(269) 465-3001
NPI assigned
Apr 23, 2008
Last updated
Apr 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2008

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

Authorized official

Name
Dr. Kenneth J Kieft, DDSNPI 1801939491
Title
President
Phone
(269) 465-3001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 2901009243 MI Primary

Addresses

Primary practice location

9500 Red Arrow Hwy
Bridgman, MI 49106-9593

Mailing address

9500 Red Arrow Hwy
P.O. Box 769
Bridgman, MI 49106-9593
Phone (269) 465-3001

Other names 1

  • Red Arrow Dentistry Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208908800000",
    "number": "1124293048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 RED ARROW HWY",
            "address_2": "P.O. BOX 769",
            "city": "BRIDGMAN",
            "state": "MI",
            "postal_code": "491069593",
            "telephone_number": "269-465-3001",
            "fax_number": "269-465-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 RED ARROW HWY",
            "city": "BRIDGMAN",
            "state": "MI",
            "postal_code": "491069593",
            "telephone_number": "269-465-3001",
            "fax_number": "269-465-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH J. KIEFT DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-23",
        "last_updated": "2008-04-23",
        "status": "A",
        "authorized_official_last_name": "KIEFT",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "269-465-3001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901009243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red Arrow Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bridgman, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; 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.