Charles Douglas Kirksey, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401005454 Issued in VA

Practice address

10611 Judicial Dr
Fairfax, VA 22030-5165

Phone

(703) 385-0303

Fax

(703) 385-1445

NPI assigned

Apr 23, 2008

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

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Charles D, Kirksey, DDS, LLC

  • General Practice Dentistry
  • Fairfax, VA
  • NPI 1871584110
  NPD (past)

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473897600000",
    "number": "1871768622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10611 JUDICIAL DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220305165",
            "telephone_number": "703-385-0303",
            "fax_number": "703-385-1445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10611 JUDICIAL DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220305165",
            "telephone_number": "703-385-0303",
            "fax_number": "703-385-1445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKSEY",
        "first_name": "CHARLES",
        "middle_name": "DOUGLAS",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-23",
        "last_updated": "2016-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401005454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Ann Kinney, FNP
• Kintsugi Counseling & Wellness PLLC
• Jamie Michelle Kirby, CRNA
• William C Kirby, M.D.
• Kristen Louise Kirk, DPT
• Janna Kirr
• Cynthia Kirschenbaum
• Kevin Kisiedu, OT
• Molly McHale Kisiel, FNP-BC
• Eric William Kisling

• General Practice Dentistry in Fairfax, VA
• Providers in Fairfax, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.