Susan L Wheeler Molstad, DDS
Individual provider Active NPI General Practice Dentistry · Ellis, KS
NPI 1295711844 · NPPES record last updated Jan 10, 2013
Key facts
- NPI
- 1295711844
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 6515 (KS)
- Practice address
- 814 Jefferson St
Ellis, KS 67637-2215 - Phone
- (785) 726-3557
- NPI assigned
- Dec 15, 2005
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6515 | KS | Yes |
Addresses
Primary practice location
814 Jefferson St
Ellis, KS 67637-2215
Mailing address
814 Jefferson St
Ellis, KS 67637-2215
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4054858601 | Medicaid | KS | |
| 100223820-A | Other | KS | DORAL PROVIDER NUMBER |
Other providers in Ellis, KS
- The Evangelical Lutheran Good Samaritan Society
- John S Thomason
- Trego County Lemke Memorial Hospital
- Nicole Walt
- Heather Werth
- Carolyn M Young
All providers in Ellis, KS · General Practice Dentistry in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.