Annie Roberts, DDS – Dentist in La Cygne, KS

Key facts

NPI: 1043748411
Entity type: Individual (NPI type 1)
Primary specialty: Dentist 122300000X
License: 61400 (KS)
Practice address: 113 N Broadway St
La Cygne, KS 66040-4205
Phone: (913) 757-4429
NPI assigned: May 31, 2017
Sex: Female
Sole proprietor: No

Organizations & group practices 2

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.

Roberts Family Dental Care LLC Dentist · La Cygne, KS · NPI 1265961007

NPD (past) Authorized official DENTIST
Dr William J McKee DDS Dentist · Lacygne, KS · NPI 1902884927

NPD (past) DENTIST

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
61400	KS	MD	Dentist

Practice roles

Organization	Specialty	Status	New patients
Dr William J McKee DDS	Dentist	Past	Accepting new patients
Roberts Family Dental Care LLC	Dentist	Past since Jul 24, 2022	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Dentist	122300000X	61400	KS	Yes

Addresses

Primary practice location

113 N Broadway St
La Cygne, KS 66040-4205

Mailing address

211 E Park St
Pleasanton, KS 66075-4065
Phone (913) 235-1141

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 31, 2017.

{
    "created_epoch": "1496188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496188800000",
    "number": "1043748411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E PARK ST",
            "city": "PLEASANTON",
            "state": "KS",
            "postal_code": "660754065",
            "telephone_number": "913-235-1141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 N BROADWAY ST",
            "city": "LA CYGNE",
            "state": "KS",
            "postal_code": "660404205",
            "telephone_number": "913-757-4429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "ANNIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-31",
        "last_updated": "2017-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KS",
            "license": "61400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Cygne, KS

All providers in La Cygne, KS · Dentist in Kansas

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 31, 2017. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.