Kurtis A Klotzbuecher, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9055 Issued in MN

Practice address

8711 E Point Douglas Rd S
Ste 100
Cottage Grove, MN 55016-5000

Phone

(651) 379-9892

Fax

(651) 379-9893

NPI assigned

Aug 31, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Oral Surgery

Education

Marquette University School of Dentistry, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Amery Regional Medical Center IncGroup PAC ID 2769391960, shared by 7 NPIs, 124 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298937600000",
    "number": "1669583407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 FRANCE AVE S",
            "address_2": "SUITE 415",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351805",
            "telephone_number": "952-224-9771",
            "fax_number": "952-224-9790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8711 E POINT DOUGLAS RD S",
            "address_2": "STE 100",
            "city": "COTTAGE GROVE",
            "state": "MN",
            "postal_code": "550165000",
            "telephone_number": "651-379-9892",
            "fax_number": "651-379-9893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOTZBUECHER",
        "first_name": "KURTIS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "9055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3002233-00",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kindcare Living LLC
• King David Home Health Care
• King David Home Health Care Services
• King David Home Health Care Services LLC
• Taylor Kline, MS
• Alissa Marie Knoblach
• Stacey L Ko, PA-C
• Michael P Koch, LIC SW
• Jacob S Kolosky, DPT
• Nathan Andrew Koppe, CNP

• General Practice Dentistry in Cottage Grove, MN
• Providers in Cottage Grove, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.