Individual provider Active NPI

Craig Huber, DDS

  • General Practice Dentistry
  • Wichita, KS
National Provider Identifier
1205198447
Registry record updated Jun 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
61462 Issued in KS
Practice address
233 N Hillside St
Wichita, KS 67214
Phone
(316) 440-6400
NPI assigned
Jun 13, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 61462 KS Primary
Dentist 122300000X DE60288276 WA

Addresses

Primary practice location

233 N Hillside St
Wichita, KS 67214

Mailing address

109 S Putter Dr
Andover, KS 67002-8823
Phone (509) 724-1977

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180615002173 KS Order and Referring Only - DentistPractitioner - Dentist 4880985308

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE60288276WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Valuecare Dental, LLC General Practice Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528416000000",
    "number": "1205198447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 S PUTTER DR",
            "city": "ANDOVER",
            "state": "KS",
            "postal_code": "670028823",
            "telephone_number": "509-724-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 N HILLSIDE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67214",
            "telephone_number": "316-440-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBER",
        "first_name": "CRAIG",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-13",
        "last_updated": "2018-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "61462",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60288276",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.