Michael K. Kluth, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12009126 Issued in IN

Practice address

2204 S Park Ave
Alexandria, IN 46001-8059

Phone

(765) 724-7729

Fax

(765) 724-9519

NPI assigned

Feb 12, 2007

Last updated

Jul 8, 2007By 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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083756795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7231 OAK COVE LN",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460629415",
            "telephone_number": "317-877-0420",
            "fax_number": "765-724-9519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 S PARK AVE",
            "city": "ALEXANDRIA",
            "state": "IN",
            "postal_code": "460018059",
            "telephone_number": "765-724-7729",
            "fax_number": "765-724-9519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUTH",
        "first_name": "MICHAEL",
        "middle_name": "K.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARMED FORCES",
            "identifier": "784991",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "000000089901",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9177506",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• J Chester Long II (Medicine Shoppe)
• Jfriedman - Alexandria LLC (Alexandria Family Dental)
• Claudie H. Jimenez, M.D.
• Kluth Family Dentistry Inc.
• Joni L. Kluth, D.D.S.
• Kathryn Maddox, RBT
• Corey D Martinez, DDS
• Meridian Health Services Corp
• Meridian Health Services Corp
• Anthony Dewayne Murphy, RBT

• General Practice Dentistry in Alexandria, IN
• Providers in Alexandria, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.