Active NPI
Courtney Beth Kanive, D.M.D., M.S.
- Endodontics
- Wentzville, MO
National Provider Identifier
1477656742
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 2004015771
- Practice address
- 1006 Schroeder Creek Blvd.
Suite 1006
Wentzville, MO 63385 - Phone
- (636) 327-7177
- NPI assigned
- Sep 5, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 2004015771 | MO | Primary |
Addresses
Primary practice location
1006 Schroeder Creek Blvd.
Suite 1006
Wentzville, MO 63385
Mailing address
674 Avondale Dr
Saint Peters, MO 63376-7717
Phone (636) 399-2387
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2004015771 | MO | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1477656742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "674 AVONDALE DR",
"city": "SAINT PETERS",
"state": "MO",
"postal_code": "633767717",
"telephone_number": "636-399-2387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1006 SCHROEDER CREEK BLVD.",
"address_2": "SUITE 1006",
"city": "WENTZVILLE",
"state": "MO",
"postal_code": "63385",
"telephone_number": "636-327-7177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANIVE",
"first_name": "COURTNEY",
"middle_name": "BETH",
"name_prefix": "Dr.",
"credential": "D.M.D., M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "MO",
"license": "2004015771",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wentzville, MO
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.