Individual provider Active NPI

Kristin Darrach Piper, DDS

  • Dentist
  • Waterford, MI
National Provider Identifier
1326209164
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901601155 Issued in MI
Practice address
4025 Highland Rd
Waterford, MI 48328-2134
Phone
(248) 682-6010
Fax
(937) 323-3403
NPI assigned
Jun 24, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901601155 MI Primary

Addresses

Primary practice location

4025 Highland Rd
Waterford, MI 48328-2134

Mailing address

4025 Highland Rd
Waterford, MI 48328-2134
Phone (248) 682-6010

Other identifiers 2

IdentifierTypeStateIssuer
2848913MedicaidOH
2901601155OtherMIMICHIGAN LICENSE

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
2901601155MIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1326209164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 HIGHLAND RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282134",
            "telephone_number": "248-682-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 HIGHLAND RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282134",
            "telephone_number": "248-682-6010",
            "fax_number": "937-323-3403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIPER",
        "first_name": "KRISTIN",
        "middle_name": "DARRACH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-24",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901601155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2848913",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN LICENSE",
            "identifier": "2901601155",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; 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.