Kevin M. Halub, DDS
Individual provider Active NPI General Practice Dentistry · White Cloud, MI
NPI 1275580334 · NPPES record last updated Oct 20, 2021
Key facts
- NPI
- 1275580334
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 2901014001 (MI)
- Practice address
- 1035 E Wilcox Ave
White Cloud, MI 49349-8794 - Phone
- (231) 689-1608
- Fax
- (231) 689-3162
- NPI assigned
- May 27, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151215002094 | MI | Order and Referring Only - Dentist |
7416258553 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901014001 | MI | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2901014001 | MI | Yes |
Addresses
Primary practice location
1035 E Wilcox Ave
White Cloud, MI 49349-8794
Mailing address
1615 Michigan Ave
Baldwin, MI 49304-7984
Phone (231) 745-2736
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4718084 | Medicaid | MI | |
| D800473 | Other | MI | BLUE CROSS BLUE SHEILD |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kevin.halub.p1@direct.bfhc.nextgenshare.com |
Other providers in White Cloud, MI
- Brent Glasgow
- Lori Goldin
- John Robert Greene
- Julia Gruss
- Gunnell Senior Care, LLC
- Tamerla Hamilton
- Harmonized Healing Counseling Services Inc
- Heavenly Guardians Homecare
- Hope N Hemmes
- Philip Anthony Himebaugh
All providers in White Cloud, MI · General Practice Dentistry in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 20, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.