Kaitlyn Bumberry, DDS
Individual provider Active NPI General Practice Dentistry · Washington, MO
NPI 1336749118 · NPPES record last updated Jan 11, 2022
Key facts
- NPI
- 1336749118
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 2020033202 (MO)
- Practice address
- 1111 E 6TH St
Washington, MO 63090-3308 - Phone
- (636) 239-6328
- NPI assigned
- Oct 29, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020033202 | MO | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2020033202 | MO | Yes |
Addresses
Primary practice location
1111 E 6TH St
Washington, MO 63090-3308
Mailing address
1111 E 6TH St
Washington, MO 63090-3308
Phone (636) 239-6328
Other providers in Washington, MO
- Martin Winter Brunworth
- Laurie Elizabeth Bryson
- Jessica Buchman
- Sean Buechter
- Sheila Ann Buesking
- C. Hastings, DDS, LLC
- C3 Chiropractic
- Dawn Cahill
- Erin Cammarata
- Margaret Capotosto
All providers in Washington, MO · General Practice Dentistry in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 11, 2022. 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.