Individual provider Active NPI

Kurtis Schuyler, DMD

  • Dentist
  • Washington, MO
National Provider Identifier
1700446010
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2019021350 Issued in MO
Practice address
416 Elm St Ste 3
Washington, MO 63090-2352
Phone
(636) 239-2273
NPI assigned
Jun 18, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 2019021350 MO Primary

Addresses

Primary practice location

416 Elm St Ste 3
Washington, MO 63090-2352

Mailing address

416 Elm St Ste 3
Washington, MO 63090-2352
Phone (314) 239-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20190726001609 MO Order and Referring Only - DentistPractitioner - Dentist 1759617822

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2019021350MOMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1700446010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 ELM ST STE 3",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630902352",
            "telephone_number": "314-239-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 ELM ST STE 3",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630902352",
            "telephone_number": "636-239-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUYLER",
        "first_name": "KURTIS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-18",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MO",
            "license": "2019021350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, MO

Sources for this page

Verify at the official NPI Registry.