Individual provider Active NPI

Justin R Kohlhorst, DDS

  • Periodontics
  • Garden City, KS
National Provider Identifier
1356452023
Registry record updated Sep 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
6516 Issued in KS
Practice address
2508 Caseys Dr
Garden City, KS 67846-3314
Phone
(620) 275-1878
Fax
(620) 275-2872
NPI assigned
Aug 31, 2006
Last updated
Sep 13, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 6516 KS Primary

Addresses

Primary practice location

2508 Caseys Dr
Garden City, KS 67846-3314

Mailing address

2508 Caseys Dr
Garden City, KS 67846-3314
Phone (620) 275-1878

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050406000502 KS Practitioner - Oral Surgery 5890742324 Practice locations: Garden City, KS

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2508 Caseys Dr
Garden City, KS 67846-3314
Phone (620) 275-2828

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6516KSMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
DRS Hopkins Ackerman & Drees LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1356452023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2508 CASEYS DR",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "678463314",
            "telephone_number": "620-275-1878",
            "fax_number": "620-275-2872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2508 CASEYS DR",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "678463314",
            "telephone_number": "620-275-1878",
            "fax_number": "620-275-2872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHLHORST",
        "first_name": "JUSTIN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "KS",
            "license": "6516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, KS

Sources for this page

Verify at the official NPI Registry.