Active NPI
Paul E. Kittle Jr., DDS
- Pediatric Dentistry
- Leavenworth, KS
National Provider Identifier
1740263029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 6806
- Practice address
- 309 S 2ND St
Leavenworth, KS 66048-2803 - Phone
- (913) 651-9800
- Fax
- (913) 651-8559
- NPI assigned
- Nov 21, 2005
- Last updated
- Jul 13, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 6806 | KS | Primary |
| Pediatric Dentistry | 1223P0221X | 4721 | NE | |
| Pediatric Dentistry | 1223P0221X | 2004025887 | MO |
Addresses
Primary practice location
309 S 2ND St
Leavenworth, KS 66048-2803
Mailing address
309 S 2ND St
Leavenworth, KS 66048-2803
Phone (913) 651-9800
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1005786 | Medicaid | KS | |
| 10022579B | Medicaid | KS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6806 | KS | MD | Pediatric Dentist |
| 2004025887 | MO | MD | Pediatric Dentist |
| 4721 | NE | MD | Pediatric Dentist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1740263029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "309 S 2ND ST",
"city": "LEAVENWORTH",
"state": "KS",
"postal_code": "660482803",
"telephone_number": "913-651-9800",
"fax_number": "913-651-8559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 S 2ND ST",
"city": "LEAVENWORTH",
"state": "KS",
"postal_code": "660482803",
"telephone_number": "913-651-9800",
"fax_number": "913-651-8559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KITTLE",
"first_name": "PAUL",
"middle_name": "E.",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-21",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "KS",
"license": "6806",
"primary": true
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NE",
"license": "4721",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "MO",
"license": "2004025887",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1005786",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10022579B",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Leavenworth, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.