Jenish George Kizhakkemuriyil, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS042491 Issued in PA

Practice address

5675 N Front St
Philadelphia, PA 19120-2719

Phone

(215) 224-0440

NPI assigned

Oct 22, 2019

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

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": "1571702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1164065223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 ELDER AVE",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076211506",
            "telephone_number": "201-673-6391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5675 N FRONT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191202719",
            "telephone_number": "215-224-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIZHAKKEMURIYIL",
        "first_name": "JENISH",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-22",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS042491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Primus Kittka
• Haley Danielle Kittle, MD
• Ngan Kiu
• Kiwell Nutrition Consulting, LLC
• Ezgi Kiyici
• Sarah Beth Kizun, DO
• KJK Orthodontics PC
• Lauren Ashli Kjos, PA-C
• KK Chiropractic Care PC
• KKC Home Care Services LLC

• General Practice Dentistry in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; 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.