Individual provider Active NPI

Don J Kindrachuk, DMD

  • Pediatric Dentistry
  • Raleigh, NC
National Provider Identifier
1811219488
Registry record updated Mar 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
7297 Issued in NC
Practice address
7800 Six Forks Rd
Raleigh, NC 27615-2980
Phone
(919) 847-5437
Fax
(919) 870-7471
NPI assigned
Feb 23, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 7297 NC Primary

Addresses

Primary practice location

7800 Six Forks Rd
Raleigh, NC 27615-2980

Mailing address

7800 Six Forks Rd
Raleigh, NC 27615-2980
Phone (919) 847-5437

Other identifiers 1

IdentifierTypeStateIssuer
5901210MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7297NCMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
DRS. Pfefferle and Kindrachuk Pediatric Dentistry 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": "1266883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267660800000",
    "number": "1811219488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 SIX FORKS RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276152980",
            "telephone_number": "919-847-5437",
            "fax_number": "919-870-7471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 SIX FORKS RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276152980",
            "telephone_number": "919-847-5437",
            "fax_number": "919-870-7471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINDRACHUK",
        "first_name": "DON",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-23",
        "last_updated": "2010-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NC",
            "license": "7297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5901210",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2010; 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.