Active NPI
Craig Huber, DDS
- General Practice Dentistry
- Wichita, KS
National Provider Identifier
1205198447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 61462
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180615002173 | KS | Order and Referring Only - Dentist | 4880985308 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE60288276 | WA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New 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.
-
dba Smart Teeth Management Co
- General Practice Dentistry
- Wichita, KS
- NPI 1508119280
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.