NPIMap

Organization Active NPI

Family Dentistry

  • Dental Clinic/Center
  • Ulysses, KS
National Provider Identifier
1497012702
Registry record updated Apr 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
5513 Issued in KS
Legal business name
FAMILY DENTISTRY
Practice address
113 S Main St
Suite a
Ulysses, KS 67880-2519
Phone
(620) 424-4499
Fax
(620) 424-4498
NPI assigned
Apr 12, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2012

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

Authorized official

Name
Dr. Kenneth Elwyn Bean, D.D.S.
Title
Owner/ Dentist
Phone
(620) 424-4499

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 5513 KS Primary

Addresses

Primary practice location

113 S Main St
Suite a
Ulysses, KS 67880-2519

Mailing address

113 S Main St
Suite a
Ulysses, KS 67880-2519
Phone (620) 424-4499

Other identifiers 1

IdentifierTypeStateIssuer
100225900AMedicaidKS

National Provider Directory

National Provider Directory

Locations

113 S Main St
#A
Ulysses, KS 67880
Phone (620) 356-2432

NPI Registry JSON

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334188800000",
    "number": "1497012702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 S MAIN ST",
            "address_2": "SUITE A",
            "city": "ULYSSES",
            "state": "KS",
            "postal_code": "678802519",
            "telephone_number": "620-424-4499",
            "fax_number": "620-424-4498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 S MAIN ST",
            "address_2": "SUITE A",
            "city": "ULYSSES",
            "state": "KS",
            "postal_code": "678802519",
            "telephone_number": "620-424-4499",
            "fax_number": "620-424-4498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-12",
        "last_updated": "2012-04-12",
        "status": "A",
        "authorized_official_last_name": "BEAN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "ELWYN",
        "authorized_official_title_or_position": "OWNER/ DENTIST",
        "authorized_official_telephone_number": "620-424-4499",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "KS",
            "license": "5513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100225900A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ulysses, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.