Justin James Kirkwood, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

064184 Issued in NY

Practice address

100 Great Oaks Blvd Ste 112
Albany, NY 12203-7924

Phone

(186) 826-4005

Fax

(518) 682-6402

NPI assigned

Apr 1, 2019

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 OH

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.

• Seth T Farren DDS Oral and Maxillofacial Surgery PLLC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Albany, NY
  • NPI 1992205801
  NPD (past)
• Greater Philadelphia Oms LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Elkins Park, PA
  • NPI 1699698936
  NPD (past)
• Greater Philadelphia Oral Surgery PC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Elkins Park, PA
  • NPI 1366549594
  NPD (past)

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1700348653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 ALBERT SABIN WAY, ML 0461",
            "address_2": "HOLMES HOSPITAL, OFFICE 2220",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45267",
            "telephone_number": "513-584-2586",
            "fax_number": "513-584-1125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GREAT OAKS BLVD STE 112",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122037924",
            "telephone_number": "186-826-4005",
            "fax_number": "518-682-6402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKWOOD",
        "first_name": "JUSTIN",
        "middle_name": "JAMES",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-01",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "064184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Kirby-Walsh, LCSW
• Sharon Kirby, LCSW
• Liza Kirchgraber, RN
• Rebecca A Kirchner, PHARM. D
• Olga V Kirk, PA
• Meghan Kise, PNP
• Jessica Sofranko Kisenwether, PHD
• Amanda Kistler, MD
• Artem Kitaychik
• Paulina D Kitcher, MD

• Oral and Maxillofacial Surgery (Dentist) in Albany, NY
• Providers in Albany, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; 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.