Individual provider Active NPI

Christian L Kanar, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Portage, MI
National Provider Identifier
1952361594
Registry record updated Jun 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
2901016278 Issued in MI
Practice address
3801 Glenkerry CT
Portage, MI 49024-0718
Phone
(269) 323-1527
Fax
(269) 323-1670
NPI assigned
Mar 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 2901016278 MI Primary

Addresses

Primary practice location

3801 Glenkerry CT
Portage, MI 49024-0718

Mailing address

3801 Glenkerry CT
Portage, MI 49024-0718
Phone (269) 323-1527

Other identifiers 2

IdentifierTypeStateIssuer
4133426MedicaidMI
4168412MedicaidMI

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110121000520 MI Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 0749469047 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial SurgeryAlso: Oral Surgery
Education
University of Michigan School of Dentistry, 1993
Medicare assignment
May accept Medicare assignment
Group practices
Kalamazoo Oral and Maxillofacial Surgery PCGroup PAC ID 5092994384, 4 clinicians

Practice addresses (Care Compare)

3801 Glenkerry CT
Suite 2
Portage, MI 49024-0711
Phone (269) 323-1527

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901016278MIMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Kalamazoo Oral & Maxillofacial Surgery, P.C. Oral and Maxillofacial Surgery CurrentSince Oct 1, 2000 Accepting new patients

Locations

3801 Glenkerry Ct
Portage, MI 49024
Phone (269) 323-1527

3801 Glenkerry Ct
Ste 2
Portage, MI 49024
Phone (269) 323-1527

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275955200000",
    "number": "1952361594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 GLENKERRY CT",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490240718",
            "telephone_number": "269-323-1527",
            "fax_number": "269-323-1670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 GLENKERRY CT",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490240718",
            "telephone_number": "269-323-1527",
            "fax_number": "269-323-1670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANAR",
        "first_name": "CHRISTIAN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2010-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2901016278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4133426",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4168412",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

Verify at the official NPI Registry.