Stacey R Kutsch, D.D.S

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DE00010428 Issued in WA

Practice address

7501 W Deschutes PL
Kennewick, WA 99336-7719

Phone

(509) 783-1960

Fax

(509) 783-7576

NPI assigned

Oct 11, 2006

Sex

Female

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 3

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.

• Stacey Kutsch, D.D.S., M.S., PLLC

  • Pediatric Dentistry
  • Ave Maria, FL
  • NPI 1265381610
  NPD Authorized official

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1285723296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7501 W DESCHUTES PL",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367719",
            "telephone_number": "509-783-1960",
            "fax_number": "509-783-7576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7501 W DESCHUTES PL",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367719",
            "telephone_number": "509-783-1960",
            "fax_number": "509-783-7576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTSCH",
        "first_name": "STACEY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "DE00010428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5050265",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONSCIOUS SEDATION",
            "identifier": "CS10000430",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5036876",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Csilla Lenart Kuehn
• John Austin Kulp III, D.MIN., M.A., M.DIV.
• Rodney D Kump, DPT
• Emily Raeann Kurzawa, L.M.P
• Zena Kuseybi, ARNP
• Kyle Rowley DDS, PLLC
• Derrick Dewayne Kyle
• Laboratory Corporation of America
• Laboratory Corporation of America
• Laboratory Corporation of America

• Pediatric Dentistry in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Pediatric Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.