Individual provider Active NPI

George Russell Kirkland Jr., D.D.S.

  • General Practice Dentistry
  • Santa Fe, NM
National Provider Identifier
1346463510
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1794 Issued in NM
Practice address
400 Botulph LN
Santa Fe, NM 87505-6911
Phone
(505) 988-3500
NPI assigned
Apr 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1794 NM Primary

Addresses

Primary practice location

400 Botulph LN
Santa Fe, NM 87505-6911

Mailing address

44 Puye Rd
Santa Fe, NM 87505-9079

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
1794NMMDPeer Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Leslie E. Lakind, D.D.S., P.C. General Practice Past Accepting new patients

Organizations & group practices 1

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": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346463510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 PUYE RD",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875059079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 BOTULPH LN",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875056911",
            "telephone_number": "505-988-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKLAND",
        "first_name": "GEORGE",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "1794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.