Individual provider Active NPI

Timothy Walter Kutas, D.D.S.

  • General Practice Dentistry
  • Memphis, TN
National Provider Identifier
1750476099
Registry record updated Dec 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS7087 Issued in TN
Practice address
519 N Highland St
Memphis, TN 38122-4521
Phone
(901) 327-5604
NPI assigned
Oct 3, 2006
Last updated
Dec 14, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS7087 TN Primary

Addresses

Primary practice location

519 N Highland St
Memphis, TN 38122-4521

Mailing address

519 N Highland St
Memphis, TN 38122-4521
Phone (901) 327-5604

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160203001726 TN Order and Referring Only - Other (Non-Physician) 8022312537

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS7087TNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Timothy W. Kutas D.D.S. Past Accepting new patients

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197590400000",
    "number": "1750476099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 N HIGHLAND ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381224521",
            "telephone_number": "901-327-5604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 N HIGHLAND ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381224521",
            "telephone_number": "901-327-5604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTAS",
        "first_name": "TIMOTHY",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS7087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.