Individual provider Active NPI

Kyle Direnzo, DMD

  • Dentist
  • Ann Arbor, MI
National Provider Identifier
1841784832
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901022658 Issued in MI
Practice address
2240 S Huron Pkwy
Ann Arbor, MI 48104-5151
Phone
(734) 677-2156
Fax
(734) 704-0006
NPI assigned
Jun 21, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901022658 MI Primary

Addresses

Primary practice location

2240 S Huron Pkwy
Ann Arbor, MI 48104-5151

Mailing address

1734 Barrington PL
Ann Arbor, MI 48103-5607

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
2901022658MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Direnzo Dental, PLLC CurrentSince Dec 14, 2025 Accepting new patients
Shannon Norman-Kotre, DDS, PLLC PastSince Dec 14, 2025 Accepting new patients

Locations

2240 S Huron Pkwy
Ann Arbor, MI 48104
Phone (734) 677-2156

Organizations & group practices 2

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": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1841784832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1734 BARRINGTON PL",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481035607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 S HURON PKWY",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481045151",
            "telephone_number": "734-677-2156",
            "fax_number": "734-704-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIRENZO",
        "first_name": "KYLE",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-21",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901022658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.