Kenneth Eugene Dambacher, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101008768 Issued in MI

Practice address

251 E Peck Rd
Peck, MI 48466-9589

Phone

(810) 378-4900

Fax

(810) 378-4905

NPI assigned

Dec 22, 2005

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 13, 2026.

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1194701946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 129",
            "city": "YALE",
            "state": "MI",
            "postal_code": "48097",
            "telephone_number": "810-387-2175",
            "fax_number": "810-378-4905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 E PECK RD",
            "city": "PECK",
            "state": "MI",
            "postal_code": "484669589",
            "telephone_number": "810-378-4900",
            "fax_number": "810-378-4905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMBACHER",
        "first_name": "KENNETH",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101008768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "0857600424",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Peck, MI
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.