Individual provider Active NPI

David George Kardynal, DDS

  • Dentist
  • Shelby Township, MI
National Provider Identifier
1780733972
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14490 Issued in MI
Practice address
48635 Hayes
Shelby Township, MI 48315
Phone
(586) 247-2250
Fax
(586) 247-8428
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 14490 MI Primary

Addresses

Primary practice location

48635 Hayes
Shelby Township, MI 48315

Mailing address

48635 Hayes
Shelby Township, MI 48315
Phone (586) 247-2250

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20161208000303 MI Order and Referring Only - DentistPractitioner - Dentist 9931157955

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14490MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
David G. Kardynal DDS CurrentSince Aug 2, 2020 Accepting new patients
MGM Dental Dentist Past Accepting new patients

Locations

48635 Hayes Rd
Shelby Township, MI 48315
Phone (586) 247-2250

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780733972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48635 HAYES",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "48315",
            "telephone_number": "586-247-2250",
            "fax_number": "586-247-8428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48635 HAYES",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "48315",
            "telephone_number": "586-247-2250",
            "fax_number": "586-247-8428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARDYNAL",
        "first_name": "DAVID",
        "middle_name": "GEORGE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "14490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

Verify at the official NPI Registry.