Jeffrey Kyle Maples, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2017023599 Issued in MO

Practice address

1324 E Montclair St
Springfield, MO 65804-4245

Phone

(417) 886-9939

NPI assigned

Jul 17, 2017

Last updated

Oct 5, 2018By 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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 22, 2020 through Oct 22, 2026

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.

• Kmaples Enterprises LLC

  dba Mapletree Dentistry

  • Dentist
  • Forsyth, MO
  • NPI 1902581283
  NPD Authorized official

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

{
    "created_epoch": "1500249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538697600000",
    "number": "1174045603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 E MONTCLAIR ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044245",
            "telephone_number": "417-886-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 E MONTCLAIR ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044245",
            "telephone_number": "417-886-9939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAPLES",
        "first_name": "JEFFREY",
        "middle_name": "KYLE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-17",
        "last_updated": "2018-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2017023599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE OF MISSOURI",
            "identifier": "2017023599",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine Manor
• Claudine Mansour, D.O.
• Marcelo J. Mantala, MD
• Usha P. Manusmare, MD
• Kierin Manzari, M.S. CCC-SLP
• Makenzie Ryan Maples
• Sara Maples
• Maranatha Village, Inc.
• Cheryl L. Maras, MS. LPC
• Hiawatha David Marban

• General Practice Dentistry in Springfield, MO
• Providers in Springfield, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.