Dirk G Rennick, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

13500 Issued in MI

Practice address

611 N Shiawassee St
Corunna, MI 48817-1039

Phone

(989) 743-4851

Fax

(989) 743-3169

NPI assigned

Sep 6, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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 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

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.

• Riverglow Dental PLLC

  dba Riverview Dental

  • Dental Clinic/Center
  • Corunna, MI
  • NPI 1194672469
  NPD (past)
• Riverview Dental, PC

  • General Practice Dentistry
  • Corunna, MI
  • NPI 1881699239
  NPD (past)

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679676845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 N SHIAWASSEE ST",
            "city": "CORUNNA",
            "state": "MI",
            "postal_code": "488171039",
            "telephone_number": "989-743-4851",
            "fax_number": "989-743-3169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 N SHIAWASSEE ST",
            "city": "CORUNNA",
            "state": "MI",
            "postal_code": "488171039",
            "telephone_number": "989-743-4851",
            "fax_number": "989-743-3169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENNICK",
        "first_name": "DIRK",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "13500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catelynn Renee Pittenger
• Staci L Pletcher, RN
• Mallory Sue Poisson-Brown, HHA
• Recovery Pathways, LLC
• Cindy Lee Reichert-Brooks, FNP
• Riverglow Dental PLLC (Riverview Dental)
• Riverview Dental, PC
• Christy Jo Sawyer
• Shiawassee Regional Education Service District
• Robin Sue Spaleny, RN

• General Practice Dentistry in Corunna, MI
• Providers in Corunna, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.