Keith G. Hulfeld, DDS

Key facts

NPI

1114098795

Entity type

Individual (NPI type 1)

Primary specialty

General Practice Dentistry 1223G0001X

License

013115 (MO)

Practice address

301 E Chestnut St
Carthage, MO 64836-2307

Phone

(417) 358-2013

Fax

(417) 358-3755

NPI assigned

Nov 13, 2006

Sex

Male

Sole proprietor

No

Organizations & group practices 1

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.

• Wesley Schemmer, DDS, LLC Dental Clinic/Center · Carthage, MO · NPI 1336965920
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114098795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E CHESTNUT ST",
            "city": "CARTHAGE",
            "state": "MO",
            "postal_code": "648362307",
            "telephone_number": "417-358-2013",
            "fax_number": "417-358-3755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E CHESTNUT ST",
            "city": "CARTHAGE",
            "state": "MO",
            "postal_code": "648362307",
            "telephone_number": "417-358-2013",
            "fax_number": "417-358-3755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HULFELD",
        "first_name": "KEITH",
        "middle_name": "G.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "013115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Carthage, MO · General Practice Dentistry in Missouri