Active NPI
Kyle Lon Vonk, D.D.S.
- Dentist
- Saint Joseph, MI
National Provider Identifier
1174614226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901016338
- Practice address
- 2607 S Cleveland Ave
Saint Joseph, MI 49085-3001 - Phone
- (269) 428-4430
- Fax
- (269) 428-0037
- NPI assigned
- Sep 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901016338 | MI | Primary |
Addresses
Primary practice location
2607 S Cleveland Ave
Saint Joseph, MI 49085-3001
Mailing address
2607 S Cleveland Ave
Saint Joseph, MI 49085-3001
Phone (269) 428-4430
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901016338 | MI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kyle L. Vonk DDS P.C. | Dentist | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Dentist
- St. Joseph, MI
- NPI 1134668460
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174614226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2607 S CLEVELAND AVE",
"city": "SAINT JOSEPH",
"state": "MI",
"postal_code": "490853001",
"telephone_number": "269-428-4430",
"fax_number": "269-428-0037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2607 S CLEVELAND AVE",
"city": "SAINT JOSEPH",
"state": "MI",
"postal_code": "490853001",
"telephone_number": "269-428-4430",
"fax_number": "269-428-0037"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VONK",
"first_name": "KYLE",
"middle_name": "LON",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901016338",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Joseph, MI
Sources for this page
- 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.