Provider Demographics
NPI:1851425342
Name:KIRKUP, MICHELE L (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:L
Last Name:KIRKUP
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:MICHELE
Other - Middle Name:L
Other - Last Name:POST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1121 W. MICHIGAN ST.
Mailing Address - Street 2:DS 307B
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-5186
Mailing Address - Country:US
Mailing Address - Phone:317-278-3398
Mailing Address - Fax:317-274-2603
Practice Address - Street 1:1121 W. MICHIGAN ST.
Practice Address - Street 2:DS 307B
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5186
Practice Address - Country:US
Practice Address - Phone:317-278-3398
Practice Address - Fax:317-274-2603
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010840A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice