Active NPI
Kyle Gilbert Stallbaumer, DDS
- Dentist
- Sabetha, KS
National Provider Identifier
1376111492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 61488
- Practice address
- 112 N 9TH St
Sabetha, KS 66534-1806 - Phone
- (785) 284-2323
- NPI assigned
- Jun 15, 2021
- Last updated
- Jun 15, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 61488 | KS | Primary |
Addresses
Primary practice location
112 N 9TH St
Sabetha, KS 66534-1806
Mailing address
1680 Kansas Rd
Sabetha, KS 66534-2505
Phone (785) 285-1830
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
| License | State | Type | Specialty |
|---|---|---|---|
| 61488 | KS | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sabetha Dental 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.
-
- Dental Clinic/Center
- Sabetha, KS
- NPI 1457920548
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623715200000",
"number": "1376111492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1680 KANSAS RD",
"city": "SABETHA",
"state": "KS",
"postal_code": "665342505",
"telephone_number": "785-285-1830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 N 9TH ST",
"city": "SABETHA",
"state": "KS",
"postal_code": "665341806",
"telephone_number": "785-284-2323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STALLBAUMER",
"first_name": "KYLE",
"middle_name": "GILBERT",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-06-15",
"last_updated": "2021-06-15",
"certification_date": "2021-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KS",
"license": "61488",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sabetha, KS
- Sabetha Pharmacy Inc (Sabetha Pharmacy)
- Sabetha Pharmacy Inc (Sabetha Pharmacy)
- Sabetha Residential, LLC (Cobblestone COurt)
- Simpson Chiropractic PA (Simpson Chiropractic &simpson Lukert Chiropractic)
- William T. Simpson, D.C.
- Steadfast Advocacy for Meaningful Independence LLC (Sami LLC)
- Elizabeth Tedman, DMD
- Total Renal Care Inc (Sabetha Dialysis)
- Christian R Tramp, M.D.
- Usd 113 Prairie Hills
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.