Individual provider Active NPI

Charles Twietmeyer, D.M.D.

  • General Practice Dentistry
  • Wichita, KS
National Provider Identifier
1053763714
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
61241 Issued in KS
Practice address
3920 W 31St St S
Wichita, KS 67217-1112
Phone
(316) 942-3113
NPI assigned
Jul 6, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 61241 KS Primary

Addresses

Primary practice location

3920 W 31St St S
Wichita, KS 67217-1112

Mailing address

3920 W 31St St S
Wichita, KS 67217-1112
Phone (316) 942-3113

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
61241KSMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Twietmeyer Family Dentistry LLC CurrentSince Nov 29, 2020 Accepting new patients
Twietmeyer Dentistry PA General Practice Past Accepting new patients

Locations

3920 W 31st St S
Wichita, KS 67217
Phone (316) 942-3113

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.

NPI Registry JSON

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

{
    "created_epoch": "1467763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1053763714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3920 W 31ST ST S",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672171112",
            "telephone_number": "316-942-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 W 31ST ST S",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672171112",
            "telephone_number": "316-942-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TWIETMEYER",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-06",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "61241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; 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.