Active NPI
Theodore John Kula III, DDS MSD
- Pediatric Dentistry
- Terre Haute, IN
National Provider Identifier
1548714868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 12012170A
- Practice address
- 800 Poplar St
Terre Haute, IN 47807 - Phone
- (812) 234-7322
- Fax
- (812) 234-2065
- NPI assigned
- Aug 4, 2016
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 12012170A | IN | Primary |
Addresses
Primary practice location
800 Poplar St
Terre Haute, IN 47807
Mailing address
800 Poplar St
Dentistry Just for Kids and Orthodonics
Terre Haute, IN 47807
Phone (812) 234-7322
Other names 1
- Mr. Tadziu John Kula III
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 |
|---|---|---|---|
| 12012170A | IN | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dentistry Just for Kids,P.C. | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatric Dentistry
- Terre Haute, IN
- NPI 1720140684
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470268800000",
"number": "1548714868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 POPLAR ST",
"address_2": "DENTISTRY JUST FOR KIDS AND ORTHODONICS",
"city": "TERRE HAUTE",
"state": "IN",
"postal_code": "47807",
"telephone_number": "812-234-7322",
"fax_number": "812-234-2065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 POPLAR ST",
"city": "TERRE HAUTE",
"state": "IN",
"postal_code": "47807",
"telephone_number": "812-234-7322",
"fax_number": "812-234-2065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KULA",
"first_name": "THEODORE",
"middle_name": "JOHN",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "DDS MSD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-04",
"last_updated": "2016-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "IN",
"license": "12012170A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TADZIU",
"last_name": "KULA",
"middle_name": "JOHN",
"prefix": "MR.",
"suffix": "III",
"credential": "DDS MSD",
"code": "5",
"type": "Other Name"
}
]
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.