Joseph Kurt Retrum, DMD, MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

12012373A Issued in IN

Practice address

4010 1St Division Rd
Fort Riley, KS 66442

Phone

(785) 239-4173

NPI assigned

Aug 17, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Retco LLC.

  • Periodontics
  • Greenfield, IN
  • NPI 1811842487
  NPD Authorized official

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

{
    "created_epoch": "1439769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1326414103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 DICKENS AVE",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665032465",
            "telephone_number": "317-418-3870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 1ST DIVISION RD",
            "city": "FORT RILEY",
            "state": "KS",
            "postal_code": "66442",
            "telephone_number": "785-239-4173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETRUM",
        "first_name": "JOSEPH",
        "middle_name": "KURT",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-17",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12012373A",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IN",
            "license": "12012373A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isaac Christian Reeb, RD
• Gabriel Isaac Reed, PSYD
• Shannon Renae Reineke, R.D.H.,B.S.H.M.
• Leland C Reitz, M.D.
• Daniel Renfer, D.O.
• Lori A Rilat, LMSW
• Travis L Robbins, PT
• Craig Roberts
• Kelly Robinson, PA-C
• Roshanna Louise Robinson, LSCSW

• Periodontics in Fort Riley, KS
• Providers in Fort Riley, KS by specialty
• Periodontics in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.