NPIMap

Individual provider Active NPI

Jessica M Kepler, DDS

  • General Practice Dentistry
  • Kansas City, KS
National Provider Identifier
1366880213
Registry record updated Mar 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
60990 Issued in KS
Practice address
4655 State Ave
Kansas City, KS 66102-3603
Phone
(913) 287-7977
Fax
(913) 287-5022
NPI assigned
Jun 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 60990 KS Primary

Addresses

Primary practice location

4655 State Ave
Kansas City, KS 66102-3603

Mailing address

4655 State Ave
Kansas City, KS 66102-3601
Phone (913) 287-7977

Other identifiers 3

IdentifierTypeStateIssuer
1366880213MedicaidMO
2891559OtherKSUNITED CONCORDIA
201072700CMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
60990KSMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
The Indian Springs Dental Clinic, LLC General Practice Past Accepting new patients
North Carriage Dental PA General Practice Past Accepting new patients
47TH Street Dental Center, LLC General Practice Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427328000000",
    "number": "1366880213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4655 STATE AVE",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661023601",
            "telephone_number": "913-287-7977",
            "fax_number": "913-287-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4655 STATE AVE",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661023603",
            "telephone_number": "913-287-7977",
            "fax_number": "913-287-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEPLER",
        "first_name": "JESSICA",
        "middle_name": "M",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-12",
        "last_updated": "2015-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "60990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366880213",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "2891559",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201072700C",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; 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.