Individual provider Active NPI

Kyle James Neuschaefer, DDS

  • Dentist
  • Saint Charles, MO
National Provider Identifier
1639528540
Registry record updated Jan 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2019008752 Issued in MO
Practice address
1319 Caulks Hill Rd
Saint Charles, MO 63304-6863
Phone
(636) 441-3430
NPI assigned
Jun 10, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1001346-15 WI
Dentist 122300000X 2019008752 MO Primary

Addresses

Primary practice location

1319 Caulks Hill Rd
Saint Charles, MO 63304-6863

Mailing address

1319 Caulks Hill Rd
Saint Charles, MO 63304-6863
Phone (636) 441-3430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161212000113 WI Order and Referring Only - DentistPractitioner - Dentist 7618257577

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2019008752MOMDDentist
1001346-15WIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Thompson and Moore, D.D.S., P.C. Past Accepting new patients
Caulks Hill Dental LLC Past Accepting new patients
Keystone West Allis LLC West Allis Dental Care PastSince Feb 23, 2020 Accepting new patients
Douglas Persich, DDS Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1465516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769731200000",
    "number": "1639528540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 CAULKS HILL RD",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633046863",
            "telephone_number": "636-441-3430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 CAULKS HILL RD",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633046863",
            "telephone_number": "636-441-3430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEUSCHAEFER",
        "first_name": "KYLE",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-10",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1001346-15",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2019008752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

Verify at the official NPI Registry.