Kimberly Marion Barbour, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901601061 Issued in MI

Practice address

312 Crocker Blvd
Mount Clemens, MI 48043-2547

Phone

(586) 469-6336

NPI assigned

Jun 29, 2021

Last updated

Jun 29, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gary Gilbert DDS

  • Dentist
  • Mount Clemens, MI
  • NPI 1295343721
  NPD

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1376113555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 CRANFORD LN",
            "city": "GROSSE POINTE",
            "state": "MI",
            "postal_code": "482301546",
            "telephone_number": "313-949-6424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 CROCKER BLVD",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432547",
            "telephone_number": "586-469-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARBOUR",
        "first_name": "KIMBERLY",
        "middle_name": "MARION",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901601061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Mount Clemens, MI
• Providers in Mount Clemens, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; 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.