Active NPI
Renee Elizabeth Kirkpatrick, DDS
- Dentist
- Fenton, MI
National Provider Identifier
1639377211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 290109667
- Practice address
- 111 S Walnut St
Fenton, MI 48430-2150 - Phone
- (810) 629-9432
- NPI assigned
- Jul 5, 2007
- Last updated
- Dec 3, 2015
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 290109667 | MI | Primary |
Addresses
Primary practice location
111 S Walnut St
Fenton, MI 48430-2150
Mailing address
111 S Walnut St
Fenton, MI 48430-2150
Phone (810) 629-9432
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160314002275 | MI | Order and Referring Only - Other (Physician) | 9931350113 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 290109667 | MI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Renee Kirkpatrick DDS PLLC | Dentist | Current | Accepting new patients |
| David M Juliani DDS PLLC | Past | Accepting new patients |
Locations
111 S Walnut St
Fenton, MI 48430
Phone (248) 629-9432
Organizations & group practices 2
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.
-
- General Practice Dentistry
- Rochester Hills, MI
- NPI 1043574072
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449100800000",
"number": "1639377211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 S WALNUT ST",
"city": "FENTON",
"state": "MI",
"postal_code": "484302150",
"telephone_number": "810-629-9432"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 S WALNUT ST",
"city": "FENTON",
"state": "MI",
"postal_code": "484302150",
"telephone_number": "810-629-9432"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIRKPATRICK",
"first_name": "RENEE",
"middle_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-05",
"last_updated": "2015-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "290109667",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fenton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2015; 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.