Mitchell Ryan Kaus, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7906 Issued in NE

Practice address

4830 Saint Paul Ave
Lincoln, NE 68504-2661

Phone

(024) 662-2114

NPI assigned

May 23, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Uptown DDS LLC

  • Dental Clinic/Center
  • Lincoln, NE
  • NPI 1720854540
  NPD Authorized official
• Unmc College of Dentistry

  • Dentist
  • Lincoln, NE
  • NPI 1649646746
  NPD (past)
• Canyon Modern Dentistry & Orthodontics

  • Dental Clinic/Center
  • Surprise, AZ
  • NPI 1366848897
  NPD (past)

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

{
    "created_epoch": "1653264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1710625405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4830 SAINT PAUL AVE",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685042661",
            "telephone_number": "402-466-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4830 SAINT PAUL AVE",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685042661",
            "telephone_number": "024-662-2114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 E Campus Loop S",
            "address_purpose": "LOCATION",
            "city": "Lincoln",
            "state": "NE",
            "postal_code": "685831530",
            "country_code": "US",
            "telephone_number": "402-472-1333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17081 W Greenway Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Surprise",
            "state": "AZ",
            "postal_code": "853889612",
            "country_code": "US",
            "telephone_number": "623-546-8400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAUS",
        "first_name": "MITCHELL",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-23",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D011367",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "7906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natraj Katta, MD
• Elizabeth Katzberg, D.D.S., M.S.
• Kacee Nicole Kaufman
• Breanna Kaup, MA, LMHP, CPC
• Mary Kaup, CRNA
• Becky Kavan
• Mylnn Kavan
• Douglas P Kavanaugh, P.T.
• Kacie Kavanaugh
• Tiffany M. Kavanaugh, LCSW

• General Practice Dentistry in Lincoln, NE
• Providers in Lincoln, NE by specialty
• General Practice Dentistry in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.