Active NPI
Kathleen Marie Kutalek, D.D.S.
- Periodontics
- West Windsor, NJ
National Provider Identifier
1437360641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DI16917
- Practice address
- 2025 Old Trenton Rd
West Windsor, NJ 08550-2412 - Phone
- (609) 448-2727
- Fax
- (609) 448-3763
- NPI assigned
- May 28, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DI16917 | NJ | Primary |
Addresses
Primary practice location
2025 Old Trenton Rd
West Windsor, NJ 08550-2412
Mailing address
2025 Old Trenton Rd
West Windsor, NJ 08550-2412
Phone (609) 448-2727
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Dec 30, 2015 through Dec 30, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI16917 | NJ | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1437360641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2025 OLD TRENTON RD",
"city": "WEST WINDSOR",
"state": "NJ",
"postal_code": "085502412",
"telephone_number": "609-448-2727",
"fax_number": "609-448-3763"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2025 OLD TRENTON RD",
"city": "WEST WINDSOR",
"state": "NJ",
"postal_code": "085502412",
"telephone_number": "609-448-2727",
"fax_number": "609-448-3763"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUTALEK",
"first_name": "KATHLEEN",
"middle_name": "MARIE",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "NJ",
"license": "DI16917",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Windsor, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.