Sandra Garbely Kerkovich, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

11705 Issued in MD

Practice address

215 Bloomingdale Ave
Federalsburg, MD 21632-1012

Phone

(410) 754-7583

Fax

(833) 916-1013

NPI assigned

Apr 26, 2007

Last updated

Oct 29, 2020By the provider in NPPES

Sex

Female

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

Enrolled in MD

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.

Enrollment records 1

Medicare enrollment (NPD)

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.

• Wicomico County Health Department

  • Public Health or Welfare Agency
  • Salisbury, MD
  • NPI 1508946047
  NPD (past)

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1629298146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 BLOOMINGDALE AVE",
            "city": "FEDERALSBURG",
            "state": "MD",
            "postal_code": "216321012",
            "telephone_number": "410-754-7583",
            "fax_number": "833-916-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 BLOOMINGDALE AVE",
            "city": "FEDERALSBURG",
            "state": "MD",
            "postal_code": "216321012",
            "telephone_number": "410-754-7583",
            "fax_number": "833-916-1013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARBELY KERKOVICH",
        "first_name": "SANDRA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "11705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Federalsburg, MD
• Providers in Federalsburg, MD by specialty
• Dentist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.