Individual provider Active NPI

Douk Kook

  • General Practice Dentistry
  • Gladwin, MI
National Provider Identifier
1821136714
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
25151 Issued in TX
Practice address
230 East Cedar Ave
Gladwin, MI 48624
Phone
(989) 426-4597
NPI assigned
Feb 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 25151 TX Primary

Addresses

Primary practice location

230 East Cedar Ave
Gladwin, MI 48624

Mailing address

230 East Cedar Ave
Gladwin, MI 48624
Phone (989) 426-4597

Other identifiers 1

IdentifierTypeStateIssuer
D7089MedicaidAL

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220111000531 MI Order and Referring Only - DentistPractitioner - Dentist 9830581412

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25151TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1821136714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 EAST CEDAR AVE",
            "city": "GLADWIN",
            "state": "MI",
            "postal_code": "48624",
            "telephone_number": "989-426-4597",
            "fax_number": "832-437-9157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 EAST CEDAR AVE",
            "city": "GLADWIN",
            "state": "MI",
            "postal_code": "48624",
            "telephone_number": "989-426-4597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOK",
        "first_name": "DOUK",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "25151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D7089",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gladwin, MI

Sources for this page

Verify at the official NPI Registry.