Individual provider Active NPI

Edward J Kirsch, D.D.S.

  • Dentist
  • Frankfort, IL
National Provider Identifier
1316100795
Registry record updated Jul 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019120344 Issued in IL
Practice address
590 Bankview Dr Ste a
Frankfort, IL 60423-1858
Phone
(815) 469-3373
NPI assigned
Jul 7, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019120344 IL Primary

Addresses

Primary practice location

590 Bankview Dr Ste a
Frankfort, IL 60423-1858

Mailing address

590 Bankview Dr Ste a
Frankfort, IL 60423-1858
Phone (815) 469-3373

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

LicenseStateTypeSpecialty
019120344ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
K2 Dental Care, PLLC Current Accepting new patients
Denali Dental PLLC Current Accepting new patients

Locations

590 Bankview Dr
Ste A
Frankfort, IL 60423
Phone (708) 301-9401

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215388800000",
    "number": "1316100795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 BANKVIEW DR STE A",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604231858",
            "telephone_number": "815-469-3373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 BANKVIEW DR STE A",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604231858",
            "telephone_number": "815-469-3373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRSCH",
        "first_name": "EDWARD",
        "middle_name": "J",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-07",
        "last_updated": "2008-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019120344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frankfort, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.