Christopher Tom Kirkwood, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12012684A Issued in IN

Practice address

808 E Mulberry St
Fort Branch, IN 47648-1665

Phone

(812) 753-4457

Fax

(812) 753-4458

NPI assigned

May 22, 2017

Last updated

Jul 21, 2022By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1495411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1801323886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 E MULBERRY ST",
            "city": "FORT BRANCH",
            "state": "IN",
            "postal_code": "476481665",
            "telephone_number": "812-753-4457",
            "fax_number": "812-753-4458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 E MULBERRY ST",
            "city": "FORT BRANCH",
            "state": "IN",
            "postal_code": "476481665",
            "telephone_number": "812-753-4457",
            "fax_number": "812-753-4458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKWOOD",
        "first_name": "CHRISTOPHER",
        "middle_name": "TOM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12012684A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Fort Branch, IN
• Providers in Fort Branch, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.