Douglas J Kardynal, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

17281 Issued in MI

Practice address

4098 17 Mile Rd
Sterling Heights, MI 48310-6836

Phone

(586) 978-0015

Fax

(586) 263-1660

NPI assigned

Nov 17, 2006

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 and National Provider Directory roles.

• Douglas J Kardynal PC

  dba Douglas J Kardynal DDS

  • Dentist
  • Sterling Heights, MI
  • NPI 1497873558
  NPD (past) Authorized official

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525046400000",
    "number": "1780758300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4098 17 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483106836",
            "telephone_number": "586-978-0015",
            "fax_number": "586-263-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4098 17 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483106836",
            "telephone_number": "586-978-0015",
            "fax_number": "586-263-1660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARDYNAL",
        "first_name": "DOUGLAS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2018-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "17281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; 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.