Active NPI
Eric D. Kyrk, D.D.S.
- General Practice Dentistry
- Harrah, OK
National Provider Identifier
1467583245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5790
- Practice address
- 2405 Cappella Blvd.
Harrah, OK 73045 - Phone
- (405) 309-6013
- Fax
- (405) 309-6031
- NPI assigned
- Mar 7, 2007
- Last updated
- Oct 2, 2007
- Sex
- Male
- 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 | 5790 | OK | Primary |
Addresses
Primary practice location
2405 Cappella Blvd.
Harrah, OK 73045
Mailing address
P.O. Box 1137
Harrah, OK 73045
Phone (405) 309-6013
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5790 | OK | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eric D Kyrk DDS PC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191283200000",
"number": "1467583245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 1137",
"city": "HARRAH",
"state": "OK",
"postal_code": "73045",
"telephone_number": "405-309-6013",
"fax_number": "405-309-6031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2405 CAPPELLA BLVD.",
"city": "HARRAH",
"state": "OK",
"postal_code": "73045",
"telephone_number": "405-309-6013",
"fax_number": "405-309-6031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KYRK",
"first_name": "ERIC",
"middle_name": "D.",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-07",
"last_updated": "2007-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OK",
"license": "5790",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Harrah, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.