Individual provider Active NPI

David M Kirschner, DDS

  • General Practice Dentistry
  • Detroit, MI
National Provider Identifier
1639248693
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901013874 Issued in MI
Practice address
2700 Martin Luther King Jr Blvd
Detroit, MI 48208-2576
Phone
(313) 494-6700
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901013874 MI Primary

Addresses

Primary practice location

2700 Martin Luther King Jr Blvd
Detroit, MI 48208-2576

Mailing address

25721 Coolidge Hwy
Oak Park, MI 48237-1307
Phone (248) 541-2022

Other identifiers 1

IdentifierTypeStateIssuer
1772782MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Detroit

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20160513000235 MI Order and Referring Only - DentistPractitioner - Dentist 7517256662

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1639248693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25721 COOLIDGE HWY",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482371307",
            "telephone_number": "248-541-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 MARTIN LUTHER KING JR BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482082576",
            "telephone_number": "313-494-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRSCHNER",
        "first_name": "DAVID",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901013874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1772782",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Detroit",
            "affiliation": "N",
            "address_1": "2700 Martin Luther King Jr Blvd",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482082576",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.