Kirk James Robertson, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

D5768 Issued in AZ

Practice address

1024 N San Francisco
Suite 101
Flagstaff, AZ 86001

Phone

(928) 779-0385

Fax

(928) 779-6487

NPI assigned

Sep 11, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Around the Mountain Pediatric Dentistry PLLC

  • Pediatric Dentistry
  • Flagstaff, AZ
  • NPI 1831344167
  NPD (past) Authorized official
• Thomas W Turnbull DDS PC

  • Pediatric Dentistry
  • Flagstaff, AZ
  • NPI 1760544704
  NPD (past)

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699879700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1773 W SEQUOIA DRIVE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "86001",
            "telephone_number": "928-213-5559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 N SAN FRANCISCO",
            "address_2": "SUITE 101",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "86001",
            "telephone_number": "928-779-0385",
            "fax_number": "928-779-6487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "KIRK",
        "middle_name": "JAMES",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AZ",
            "license": "D5768",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OR",
            "license": "D8245",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Audrey Jean Roberts, MD
• Diana Ray Roberts, COTA/L
• Jennifer Roberts
• Brittany Robertson, M.D.
• Jessica Lorraine Robertson, DMD
• Jonathan David Robinson, D.D.S.
• Carrie Roby, RN
• Jeffrey P Rockow, M.D.
• Sasha Yasmin Rodriguez
• George W. Rodway, PHD, APRN-NP

• Pediatric Dentistry in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Pediatric Dentistry in Arizona

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.