316 Family Dental LLC
Organization Active NPI General Practice Dentistry · Newton, KS
NPI 1679187686 · NPPES record last updated Jan 1, 2022
Key facts
- NPI
- 1679187686
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- Legal business name
- 316 FAMILY DENTAL LLC
- Practice address
- 606 N Main St Ste 102
Newton, KS 67114-2219 - Phone
- (316) 283-0110
- Fax
- (316) 283-0736
- NPI assigned
- Sep 8, 2020
- Organization subpart
- No
Authorized official
- Name
- Dr. Andrew J. Mettman, DDS
- Title
- Owner/Dentist
- Phone
- (316) 650-1774
Practitioners 2
-
Andrew J. Mettman, D.D.S.
-
Gary Sickles, DDS
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220330000505 | KS | Part B Supplier - Clinic/Group Practice | 9335535483 |
Receives reassigned benefits from 1 practitioner Practice locations: Newton, KS |
National Provider Directory
Locations
606 N Main St
Ste 102
Newton, KS 67114
Phone (316) 283-0110
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | Yes |
Addresses
Primary practice location
606 N Main St Ste 102
Newton, KS 67114-2219
Mailing address
1046 S Bedford Ter
Wichita, KS 67207-4304
Phone (316) 650-1774
Other names
- Andrew J. Mettman DDS LLC
Other providers in Newton, KS
All providers in Newton, KS · General Practice Dentistry in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 1, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.