Kevin R Austin, KEVIN R. AUSTIN
Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Nixa, MO
NPI 1598091415 · NPPES record last updated Oct 28, 2009
Key facts
- NPI
- 1598091415
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
- License
- 2002014201 (MO)
- Practice address
- 708 W Mount Vernon St
Nixa, MO 65714-9682 - Phone
- (417) 725-9600
- Fax
- (417) 725-9566
- NPI assigned
- Oct 28, 2009
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2002014201 | MO | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 2002014201 | MO | Yes |
Addresses
Primary practice location
708 W Mount Vernon St
Nixa, MO 65714-9682
Mailing address
708 W Mount Vernon St
Nixa, MO 65714-9682
Phone (417) 725-9600
Other providers in Nixa, MO
- Alps Health DPC LLC
- Alps Health, LLC
- Justin Anderson
- Lana D Ansley
- Tiffany R Aucoin
- Michelle Lee Balek
- Barbara K. Hylton
- Robert Wayne Barnett
- Brendan D Beckley
- Julie Loree Baxter Bennett
All providers in Nixa, MO · Orthodontics and Dentofacial Orthopedics Dentistry in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.