Kirks Dentuer Clinic

Primary specialty

DenturistTaxonomy code 122400000X

License

DN00000170 Issued in WA

Legal business name

KIRKS DENTUER CLINIC

Practice address

2048 NE Kresky Ave
Chehalis, WA 98532-2322

Phone

(360) 740-9883

Fax

(360) 740-1894

NPI assigned

May 23, 2007

Organization subpart

No

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

Authorized official

Name

Amber Rai Delaney

Title

Office Manager

Phone

(360) 740-9883

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346450525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2048 NE KRESKY AVE",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985322322",
            "telephone_number": "360-740-9883",
            "fax_number": "360-740-1894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2048 NE KRESKY AVE",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985322322",
            "telephone_number": "360-740-9883",
            "fax_number": "360-740-1894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIRKS DENTUER CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DELANEY",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "RAI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "360-740-9883"
    },
    "taxonomies": [
        {
            "code": "122400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Denturist",
            "state": "WA",
            "license": "DN00000170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5050216",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "9118342",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Shay Kesgard, LMHC
• Kennedy R Kidrick
• Kyra Lily Kihn
• David King, CDP
• Kristina King, MD
• Esther Laura Kittle, MD
• Ranjith Kolli
• Demetri George Kollias, PHARM.D.
• Michelle Kolpin, LCSW
• Michael Koplin, AAC

• Denturist in Chehalis, WA
• Providers in Chehalis, WA by specialty
• Denturist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.