Active NPI
Kathleen Hurst Chmielewski, DDS
- General Practice Dentistry
- Brockway, MI
National Provider Identifier
1386750677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 15038
- Practice address
- 7709 Brockway Rd
Brockway, MI 48097-3411 - Phone
- (810) 387-3055
- Fax
- (810) 387-3121
- NPI assigned
- Aug 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 15038 | MI | Primary |
Addresses
Primary practice location
7709 Brockway Rd
Brockway, MI 48097-3411
Mailing address
7709 Brockway Rd
P.O. Box 153
Brockway, MI 48097-3411
Phone (810) 387-3055
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2696166 | Medicaid | MI |
Other names 1
- Kathleen Marie Hurst
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15038 | MI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421020800000",
"number": "1386750677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7709 BROCKWAY RD",
"address_2": "P.O. BOX 153",
"city": "BROCKWAY",
"state": "MI",
"postal_code": "480973411",
"telephone_number": "810-387-3055",
"fax_number": "810-387-3121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7709 BROCKWAY RD",
"city": "BROCKWAY",
"state": "MI",
"postal_code": "480973411",
"telephone_number": "810-387-3055",
"fax_number": "810-387-3121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHMIELEWSKI",
"first_name": "KATHLEEN",
"middle_name": "HURST",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-21",
"last_updated": "2015-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MI",
"license": "15038",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2696166",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KATHLEEN",
"last_name": "HURST",
"middle_name": "MARIE",
"credential": "DDS",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Brockway, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.