Kyle Donahue, DDS

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

2001005311 Issued in MO

Practice address

2020 Bluestone Dr
Saint Charles, MO 63303-5974

Phone

(636) 946-6117

Fax

(636) 946-2776

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Mar 9, 2021 through Mar 9, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Donahue Dental

  • Dentist
  • Saint Charles, MO
  • NPI 1881896769
  NPD (past) Authorized official

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374710400000",
    "number": "1487740189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 BLUESTONE DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633035974",
            "telephone_number": "636-946-6117",
            "fax_number": "636-946-2776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 BLUESTONE DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633035974",
            "telephone_number": "636-946-6117",
            "fax_number": "636-946-2776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONAHUE",
        "first_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2013-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MO",
            "license": "2001005311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Marie Doerr, M.S.
• Shearl Dolejsi, LCSW
• Joseph Doll, DC
• Jessica L Dollar, LCSW
• Donahue Dental
• Donnan Assisting LLC
• Jennifer Lynn Donnan, CSFA
• Nicole Doran, RN
• Tyler James Dordan, DC
• Tamara J. Dorey, PH.D.

• Prosthodontics in Saint Charles, MO
• Providers in Saint Charles, MO by specialty
• Prosthodontics in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2013; 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.

Verify at the official NPI Registry.