Individual provider Active NPI

Brenda Kirkendall, DDS

  • General Practice Dentistry
  • Huntsville, AL
National Provider Identifier
1790847176
Registry record updated Apr 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4441 Issued in AL
Practice address
2310 Whitesburg Dr S
#2
Huntsville, AL 35801-3845
Phone
(256) 536-8561
Fax
(256) 536-8563
NPI assigned
Dec 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4441 AL Primary

Addresses

Primary practice location

2310 Whitesburg Dr S
#2
Huntsville, AL 35801-3845

Mailing address

PO Box 5306
Huntsville, AL 35814-5306
Phone (256) 536-8561

Other identifiers 1

IdentifierTypeStateIssuer
51519698OtherALBCBS OF ALABAMA ID NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20161110002051 AL Order and Referring Only - DentistPractitioner - Dentist 9335428549

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4441ALMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dentistry Unlimited P C General Practice Past Accepting new patients

Organizations & group practices 1

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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207526400000",
    "number": "1790847176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5306",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358145306",
            "telephone_number": "256-536-8561",
            "fax_number": "256-536-8563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 WHITESBURG DR S",
            "address_2": "#2",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358013845",
            "telephone_number": "256-536-8561",
            "fax_number": "256-536-8563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKENDALL",
        "first_name": "BRENDA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2008-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "4441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ALABAMA ID NUMBER",
            "identifier": "51519698",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.