NPIMap

Organization Active NPI

Ict Dentistry LLC

  • General Practice Dentistry
  • Wichita, KS
National Provider Identifier
1558092940
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ICT DENTISTRY LLC
Practice address
3151 N Rock Rd
Wichita, KS 67226-1312
Phone
(316) 272-7876
NPI assigned
Jun 17, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Authorized official

Name
Trenton EbersoleNPI 1184297178
Title
Owner
Phone
(316) 272-7876

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

3151 N Rock Rd
Wichita, KS 67226-1312

Mailing address

PO Box 70887
Cleveland, OH 44190-0887

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1655424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687219200000",
    "number": "1558092940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70887",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441900887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3151 N ROCK RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672261312",
            "telephone_number": "316-272-7876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICT DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-17",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A",
        "authorized_official_last_name": "EBERSOLE",
        "authorized_official_first_name": "TRENTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "316-272-7876"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.