Kynan Richard Westermeyer, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D11514 Issued in MN

Practice address

404 1St St
Princeton, MN 55371-1602

Phone

(763) 389-3320

NPI assigned

Nov 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• Dr. Kynan Westermeyer, DDS, PLLC

  • Dental Clinic/Center
  • Princeton, MN
  • NPI 1780989038
  NPD (past) Authorized official
• Riverside Dental-Robert C. Beattie, DDS & Associates PC

  • General Practice Dentistry
  • Princeton, MN
  • NPI 1104994110
  NPD (past)

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275604597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13808 213TH AVE NW",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553304680",
            "telephone_number": "763-241-0455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 1ST ST",
            "city": "PRINCETON",
            "state": "MN",
            "postal_code": "553711602",
            "telephone_number": "763-389-3320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTERMEYER",
        "first_name": "KYNAN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D11514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David A Waletzko, MD
• Walmart Inc.
• Mary Frances Ward, MA: CCC
• Maria Jeanne Werner, C.M.T.
• West Central Neurology PA
• White Birch Dental, PLLC
• Jocelyn Wiedewitsch
• Lucas Burton Winskowski, LADC
• Barbara Lynn Wisniewski, LPCC
• Renae Helen Witta, OTR/L

• General Practice Dentistry in Princeton, MN
• Providers in Princeton, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.