Robert Alan Kirk, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

29697 Issued in TX

Practice address

105 Wildwood Dr
Suite 216
Georgetown, TX 78633-1343

Phone

(512) 942-6729

NPI assigned

Feb 12, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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 and National Provider Directory roles.

• Carus Dental PC

  • General Practice Dentistry
  • Georgetown, TX
  • NPI 1386913283
  NPD (past)

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434067200000",
    "number": "1669514212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 WILDWOOD DR",
            "address_2": "SUITE 216",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786331343",
            "telephone_number": "512-942-6729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 WILDWOOD DR",
            "address_2": "SUITE 216",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786331343",
            "telephone_number": "512-942-6729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "ROBERT",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2015-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SD",
            "license": "M968",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "29697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Shewmaker, P.C.
• Amy Marie King
• Ashley Rose King, NURSE PRACTITIONER
• Constance Elaine King, NP-C
• Emily Kaye Kipp-Wright, M.A., LPC
• Mikayla Kirsch, OTR, MOT
• Jeffrey William Klein, LPC
• Brandon Allen Kline, COTA
• Brett Knox
• Liesha Koch

• Dentist in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.

Verify at the official NPI Registry.