NPIMap

Organization Active NPI

Michael Kunkel DDS Professional LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Colorado Springs, CO
National Provider Identifier
1376989707
Registry record updated May 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DEN.00201943 Issued in CO
Legal business name
MICHAEL KUNKEL DDS PROFESSIONAL LLC
Practice address
3475 Briargate Blvd
Suite 102
Colorado Springs, CO 80920-4170
Phone
(719) 264-6070
Fax
(719) 264-6090
NPI assigned
May 13, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2013

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

Authorized official

Name
Dr. Michael Kunkel, D.D.S.NPI 1215190145
Title
Managing Member
Phone
(719) 264-6070

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X DEN.00201943 CO Primary

Addresses

Primary practice location

3475 Briargate Blvd
Suite 102
Colorado Springs, CO 80920-4170

Mailing address

3475 Briargate Blvd
Suite 102
Colorado Springs, CO 80920-4170
Phone (719) 264-6070

Other names 1

  • Oral and Facial Surgery Center Doing business as

National Provider Directory

National Provider Directory

Locations

3475 Briargate Blvd
Ste 102
Colorado Springs, CO 80920
Phone (719) 264-6070

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1368403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368403200000",
    "number": "1376989707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3475 BRIARGATE BLVD",
            "address_2": "SUITE 102",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809204170",
            "telephone_number": "719-264-6070",
            "fax_number": "719-264-6090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3475 BRIARGATE BLVD",
            "address_2": "SUITE 102",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809204170",
            "telephone_number": "719-264-6070",
            "fax_number": "719-264-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL KUNKEL DDS PROFESSIONAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-13",
        "last_updated": "2013-05-13",
        "status": "A",
        "authorized_official_last_name": "KUNKEL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "719-264-6070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CO",
            "license": "DEN.00201943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oral and Facial Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2013; 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.