Kid's First Pediatric Dentistry PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

2901022062 Issued in MI

Legal business name

KID'S FIRST PEDIATRIC DENTISTRY PC

Practice address

3778 Dix Hwy
Lincoln Park, MI 48146-3807

Phone

(313) 386-0570

NPI assigned

Jan 11, 2018

Last updated

Sep 27, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Caitlin Corum

Title

Assistant/Front Desk

Phone

(313) 386-0570

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sukrit Grewal

  • Pediatric Dentistry
  • Lincoln Park, MI
  • NPI 1902210065
  NPD (past)

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

{
    "created_epoch": "1515628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538006400000",
    "number": "1710495874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3778 DIX HWY",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481463807",
            "telephone_number": "313-386-0570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3778 DIX HWY",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481463807",
            "telephone_number": "313-386-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KID'S FIRST PEDIATRIC DENTISTRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-11",
        "last_updated": "2018-09-27",
        "status": "A",
        "authorized_official_last_name": "CORUM",
        "authorized_official_first_name": "CAITLIN",
        "authorized_official_title_or_position": "ASSISTANT/FRONT DESK",
        "authorized_official_telephone_number": "313-386-0570"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MI",
            "license": "2901022062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "VS0034738",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Khalil and Usen DPM PC (Family Foot and Ankle Specialist)
• Khalil and Usen DPM PC II (Family Foot and Ankle II)
• Arif Ali Khan
• Fouad Ashhar Khan, DDS
• Mahmood Khan, M.D.
• Katie Lynn Kiner, LLPC
• Mark Perry Kirsch, RPH
• Miranda Kizy, NP
• Christina Kollias, LLMSW
• Susan Ann Kozak, MSW

• Pediatric Dentistry in Lincoln Park, MI
• Providers in Lincoln Park, MI by specialty
• Pediatric Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; 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.