Active NPI
Dennis D Tietze, MD
- Family Medicine Physician
- Topeka, KS
National Provider Identifier
1053310458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 418256
- Practice address
- 1101 SW 29TH Street
Topeka, KS 66611 - Phone
- (785) 379-4600
- NPI assigned
- Jul 18, 2005
- Last updated
- Jan 8, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 418256 | KS | Primary |
Addresses
Primary practice location
1101 SW 29TH Street
Topeka, KS 66611
Mailing address
Dept CH 14389
Palatine, IL 60055-4389
Phone (785) 295-8108
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 418256 | KS | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389139200000",
"number": "1053310458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "DEPT CH 14389",
"city": "PALATINE",
"state": "IL",
"postal_code": "600554389",
"telephone_number": "785-295-8108",
"fax_number": "785-231-5991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 SW 29TH STREET",
"city": "TOPEKA",
"state": "KS",
"postal_code": "66611",
"telephone_number": "785-379-4600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIETZE",
"first_name": "DENNIS",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-18",
"last_updated": "2014-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KS",
"license": "418256",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Topeka, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.