Kevin J Kross, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901020207 Issued in MI

Practice address

4868 Lake Michigan Dr
Suite a
Allendale, MI 49401-8434

Phone

(616) 895-7400

Fax

(616) 895-4375

NPI assigned

Jun 11, 2010

Sex

Male

Sole proprietor

Yes

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 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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362441600000",
    "number": "1942521091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4868 LAKE MICHIGAN DR",
            "address_2": "SUITE A",
            "city": "ALLENDALE",
            "state": "MI",
            "postal_code": "494018434",
            "telephone_number": "616-895-7400",
            "fax_number": "616-895-4375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4868 LAKE MICHIGAN DR",
            "address_2": "SUITE A",
            "city": "ALLENDALE",
            "state": "MI",
            "postal_code": "494018434",
            "telephone_number": "616-895-7400",
            "fax_number": "616-895-4375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROSS",
        "first_name": "KEVIN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-11",
        "last_updated": "2013-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901020207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Marie Kisiel
• Mary Jo Kleyn, PTA
• Becky Lynne Kortman, COTA
• Kirsten Krause
• Jill Renee Kreuze
• Lisa K Kurek, NP
• Samantha Jo Kurk
• Tori Landman
• Joreine Patrick Landoy, FNP-BC
• Samantha Jane Lane

• General Practice Dentistry in Allendale, MI
• Providers in Allendale, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; 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.