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General NPI Number Information
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NPI Number | 1407203417
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Entity Type | Individual
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Provider Name | DANIEL SCOTT KIRK M.D., D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/19/2016
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Last Update Date | 06/07/2024
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Provider Practice Location Address
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Address Line | 2500 NESCONSET HWY BLDG 11A
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City | STONY BROOK
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State | NY
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Zip | 11790-2553
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Country | US
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Telephone | 631-203-2691
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 NESCONSET HWY BLDG 11A
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City | STONY BROOK
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State | NY
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Zip | 11790-2553
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Country | US
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Telephone | 631-203-2691
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | D13718
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | 68357
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | 29839
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License Number State | MN
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Taxonomy #4
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | 232
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License Number State | OK
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Taxonomy #5
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 063873
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License Number State | NY
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