Active NPI
Stephen Robert Kirschbaum, DDS
- General Practice Dentistry
- Liberty, MO
National Provider Identifier
1487181988
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2017014441
- Practice address
- 200 N Forest Ave
Liberty, MO 64068-1070 - Phone
- (816) 792-8030
- NPI assigned
- May 15, 2017
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2017014441 | MO | Primary |
Addresses
Primary practice location
200 N Forest Ave
Liberty, MO 64068-1070
Mailing address
380 W 22ND St Apt 605
Kansas City, MO 64108-2074
Phone (712) 348-4143
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 |
|---|---|---|---|
| 2017014441 | MO | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494806400000",
"number": "1487181988",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "380 W 22ND ST APT 605",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641082074",
"telephone_number": "712-348-4143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 N FOREST AVE",
"city": "LIBERTY",
"state": "MO",
"postal_code": "640681070",
"telephone_number": "816-792-8030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIRSCHBAUM",
"first_name": "STEPHEN",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-05-15",
"last_updated": "2017-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MO",
"license": "2017014441",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Liberty, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.