Kyle Merrick, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D14228 Issued in MN

Practice address

6460 Main St
North Branch, MN 55056-7068

Phone

(651) 674-7096

NPI assigned

Jun 5, 2019

Last updated

Jun 29, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 1, 2023 through May 1, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Richard R. Nyman, D.D.S., P.a.

  dba North Branch Dental

  • Dentist
  • North Branch, MN
  • NPI 1841418639
  NPD (past)

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1417515339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220",
            "city": "NORTH BRANCH",
            "state": "MN",
            "postal_code": "550560220",
            "telephone_number": "218-341-9584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6460 MAIN ST",
            "city": "NORTH BRANCH",
            "state": "MN",
            "postal_code": "550567068",
            "telephone_number": "651-674-7096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRICK",
        "first_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-05",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D14228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marylous Homecare
• Cari McCargar, PHARMD
• Shawn Timothy McCullough, DDS
• Adam McVey, PHARMD
• Ann M Mell, PHARMD
• Jennifer Milbrandt, PSY.D.
• Mind Works
• Minnesota Mind Body Professionals Inc
• Kara H Mireles, LAMFT
• Sarah Myer, APRN, CNP

• Dentist in North Branch, MN
• Providers in North Branch, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.