Christopher Paul Kittle, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

6427 Issued in LA

Practice address

7223 Mississippi Ave, BLDG #1561
Attn: Credentials Coordinator
Fort Polk, LA 71459-5110

Phone

(337) 531-2327

Fax

(337) 531-6356

NPI assigned

Aug 29, 2007

Last updated

Sep 22, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective May 1, 2025 through May 1, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442880000000",
    "number": "1437343829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7223 MISSISSIPPI AVENUE, BLDG #1561",
            "address_2": "USA DENTAL ACTIVITY ATTN: CREDENTIALS COORDINATOR",
            "city": "FORT POLK",
            "state": "LA",
            "postal_code": "714595110",
            "telephone_number": "337-531-2327",
            "fax_number": "337-531-6356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7223 MISSISSIPPI AVE, BLDG #1561",
            "address_2": "ATTN: CREDENTIALS COORDINATOR",
            "city": "FORT POLK",
            "state": "LA",
            "postal_code": "714595110",
            "telephone_number": "337-531-2327",
            "fax_number": "337-531-6356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITTLE",
        "first_name": "CHRISTOPHER",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-29",
        "last_updated": "2015-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "LA",
            "license": "6427",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "L476270",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohammad Farrukh Khan, MD
• Ina Uri Kim, DDS
• Myung Mi Kim, M.D.
• Devon A King
• Eric Kinsman, M.D.
• Hannah Klein, LCSW
• Julianne Kossman, RN/CCM
• Nicholas Kramer
• Christopher D Laflair, B.S.
• Kellee Sharee Lamb Wemes

• Oral and Maxillofacial Surgery (Dentist) in Fort Polk, LA
• Providers in Fort Polk, LA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.