KC Dental Group PLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

KC DENTAL GROUP PLC

Practice address

664 E Main St Ste F
Centreville, MI 49032

Phone

(269) 467-9325

Fax

(269) 467-9095

NPI assigned

Feb 13, 2025

Organization subpart

No

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

Authorized official

Name

Sheri Macdonald

Title

Office Manager

Phone

(269) 467-9325

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kris Bano, DDS

  • General Practice Dentistry
  • Centreville, MI
  • NPI 1578239430
  NPD
• Richard Stake Shields, DDS

  • General Practice Dentistry
  • Asheville, NC
  • NPI 1871601369
  NPD (past)

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

{
    "created_epoch": "1739404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739404800000",
    "number": "1982409017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "664 E MAIN ST STE F",
            "city": "CENTREVILLE",
            "state": "MI",
            "postal_code": "49032",
            "telephone_number": "269-467-9325",
            "fax_number": "269-467-9095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "664 E MAIN ST STE F",
            "city": "CENTREVILLE",
            "state": "MI",
            "postal_code": "49032",
            "telephone_number": "269-467-9325",
            "fax_number": "269-467-9095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KC DENTAL GROUP PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-13",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A",
        "authorized_official_last_name": "MACDONALD",
        "authorized_official_first_name": "SHERI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "269-467-9325"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karah Dennell Johnson, LLMSW
• Michelle Johnson, BSW
• Stevie Johnson
• Amy Jones
• Benjamin Joseph Karle, LLMSW
• Amy Marie Kemp
• Amy Jo Kern
• Heather Marie Kerr, PSYCHOLOGIST LLP
• Amanda Joy Kindig, LPC
• Dylan King

• General Practice Dentistry in Centreville, MI
• Providers in Centreville, 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 Feb 13, 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.