Individual provider Active NPI

Sandy Michelle Kirk, DDS

  • General Practice Dentistry
  • Rockingham, VA
National Provider Identifier
1811730922
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401419715 Issued in VA
Practice address
4036 Quarles CT
Rockingham, VA 22801-8716
Phone
(540) 433-2800
NPI assigned
Jun 17, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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 0401419715 VA Primary

Addresses

Primary practice location

4036 Quarles CT
Rockingham, VA 22801-8716

Mailing address

4036 Quarles CT
Rockingham, VA 22801-8716
Phone (540) 433-2800

Other names 1

  • Sandy Michelle Gomez-Henriquez Former name

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
0401419715VAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1811730922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4036 QUARLES CT",
            "city": "ROCKINGHAM",
            "state": "VA",
            "postal_code": "228018716",
            "telephone_number": "540-433-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4036 QUARLES CT",
            "city": "ROCKINGHAM",
            "state": "VA",
            "postal_code": "228018716",
            "telephone_number": "540-433-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "SANDY",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-17",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401419715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDY",
            "last_name": "GOMEZ-HENRIQUEZ",
            "middle_name": "MICHELLE",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rockingham, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2025; 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.