Active NPI
Kurt Michael Anderson, DDS
- Dentist
- Kirksville, MO
National Provider Identifier
1376274944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2022018760
- Practice address
- 402 W Jefferson St
Kirksville, MO 63501-3407 - Phone
- (660) 665-2741
- NPI assigned
- Jun 23, 2022
- Last updated
- May 14, 2026
- Sex
- Male
- Sole proprietor
- No
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 | 2022018760 | MO | Primary |
Addresses
Primary practice location
402 W Jefferson St
Kirksville, MO 63501-3407
Mailing address
20129 Highway 129
Bucklin, MO 64631-7168
Phone (660) 734-9034
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221111001783 | TX | Order and Referring Only - Oral Surgery | 6103293618 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778716800000",
"number": "1376274944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20129 HIGHWAY 129",
"city": "BUCKLIN",
"state": "MO",
"postal_code": "646317168",
"telephone_number": "660-734-9034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "402 W JEFFERSON ST",
"city": "KIRKSVILLE",
"state": "MO",
"postal_code": "635013407",
"telephone_number": "660-665-2741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "KURT",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-06-23",
"last_updated": "2026-05-14",
"certification_date": "2026-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2022018760",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kirksville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.