Connor Michael Kirtley, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12013495A Issued in IN

Practice address

325 N Walnut St Ste a
Seymour, IN 47274-2113

Phone

(812) 522-1899

Fax

(812) 522-2759

NPI assigned

Oct 7, 2020

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

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.

• Kirtley & Stuckwisch, LLC

  • General Practice Dentistry
  • Seymour, IN
  • NPI 1972613339
  NPD (past)

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

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1558968024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 N WALNUT ST STE A",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472742113",
            "telephone_number": "812-522-1899",
            "fax_number": "812-522-2759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N WALNUT ST STE A",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472742113",
            "telephone_number": "812-522-1899",
            "fax_number": "812-522-2759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRTLEY",
        "first_name": "CONNOR",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-07",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12013495A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Elizabeth Kern-Anderson, D.D.S.
• Elizabeth Keyes, PTA
• Amanda J Kile, D.O.
• Michael C Kilpatrick, MD
• Kirtley & Stuckwisch, LLC
• William Richard Kirtley, D.D.S.
• Klaes Clinic, Inc.
• Marian F. Klaes-Lanham, D.C., ACUPUNCTURE
• Christopher J. Klaes, D.C.
• Courtney Burns Kleber, M.D.

• General Practice Dentistry in Seymour, IN
• Providers in Seymour, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; 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.