Kim David Kissell, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

06878 Issued in IA

Practice address

255 Bierman Rd
Epworth, IA 52045-9529

Phone

(563) 876-3396

Fax

(563) 876-3645

NPI assigned

Feb 26, 2007

Last updated

Jun 18, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Epworth Family Dentistry PC

  • Dental Clinic/Center
  • Epworth, IA
  • NPI 1124344742
  Authorized official Same address or phone
• Epworth Family Dentistry, P.C.

  • General Practice Dentistry
  • Epworth, IA
  • NPI 1164817888
  NPD (past) Authorized official

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403049600000",
    "number": "1053447938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 BIERMAN RD",
            "address_2": "PO BOX 285",
            "city": "EPWORTH",
            "state": "IA",
            "postal_code": "520459529",
            "telephone_number": "563-876-3396",
            "fax_number": "563-876-3645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 BIERMAN RD",
            "city": "EPWORTH",
            "state": "IA",
            "postal_code": "520459529",
            "telephone_number": "563-876-3396",
            "fax_number": "563-876-3645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSELL",
        "first_name": "KIM",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2014-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "06878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Epworth Community Firemen
• Epworth Family Chiropractic, P.C.
• Epworth Family Dentistry PC
• Epworth Family Dentistry, P.C.
• Mary Jo Kelchen, D.C.
• Leslie J Kremer, PT
• Ryan T Oetken, D.D.S.
• Schipper Family Chiropractic, P.C.

• General Practice Dentistry in Epworth, IA
• Providers in Epworth, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.

Verify at the official NPI Registry.