Renata L Prose, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

KS60689 Issued in KS

Practice address

801 N Maple St
McPherson, KS 67460

Phone

(620) 241-6512

NPI assigned

Aug 22, 2006

Last updated

Nov 23, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Ms. Renata L Lichty Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mid Kansas Dental, LLC

  • General Practice Dentistry
  • McPherson, KS
  • NPI 1194276238
  NPD
• Richard J Penner, DDS

  • General Practice Dentistry
  • McPherson, KS
  • NPI 1417161118
  NPD (past)

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1225144256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 N MAPLE ST",
            "city": "MCPHERSON",
            "state": "KS",
            "postal_code": "67460",
            "telephone_number": "620-241-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N MAPLE ST",
            "city": "MCPHERSON",
            "state": "KS",
            "postal_code": "67460",
            "telephone_number": "620-241-6512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROSE",
        "first_name": "RENATA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "9879",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-022383",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "KS60689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENATA",
            "last_name": "LICHTY",
            "middle_name": "L",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jacob Drannon Perryman, APRN-FNP
• Trang Thuy Pham, OTA
• Samantha Pihl, CRNA
• Prairie View, Inc.
• Seth Prochaska, DDS
• Audra Nicole Rauchholz
• Abigail Elizabeth Reimer, CPTA
• Esther Virginia Rettig, MD
• Kristen Reynolds
• Kimberley Garrett Rich, PTA

• General Practice Dentistry in McPherson, KS
• Providers in McPherson, KS by specialty
• General Practice Dentistry in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2022; 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.

Verify at the official NPI Registry.