Perri Lynn Kauls, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9805 Issued in MN

Practice address

12 Long Lake Road
Number 12
Mahtomedi, MN 55115

Phone

(651) 770-2699

Fax

(651) 770-9896

NPI assigned

Jun 15, 2009

Last updated

Jun 15, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Perri Lynn Kilcoyne Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Dec 14, 2015 through Dec 14, 2027

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Orchard Dental Group, P.L.L.C.

  • Dentist
  • Mahtomedi, MN
  • NPI 1932335098
  NPD (past)

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

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245024000000",
    "number": "1770710972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 LONG LAKE ROAD",
            "address_2": "NUMBER 12",
            "city": "MAHTOMEDI",
            "state": "MN",
            "postal_code": "55115",
            "telephone_number": "651-770-2699",
            "fax_number": "651-770-9896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 LONG LAKE ROAD",
            "address_2": "NUMBER 12",
            "city": "MAHTOMEDI",
            "state": "MN",
            "postal_code": "55115",
            "telephone_number": "651-770-2699",
            "fax_number": "651-770-9896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAULS",
        "first_name": "PERRI",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-15",
        "last_updated": "2009-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "9805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PERRI",
            "last_name": "KILCOYNE",
            "middle_name": "LYNN",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Naima Hussien
• Kevin Hynes, LMFT
• Isd 832 - Mahtomedi School District
• Jessica Dresden PSYD LP LLC
• Virginia Rose Kampmeier, D.C.
• Kathleen Ann Keefe, PHYSICAL THERAPIST A
• Amariah Kirui, LICSW
• Lake Shore Treatement Center LLC (Eosis Lakeshore)
• Kathryn Marie Laliberte
• Colette Lang

• General Practice Dentistry in Mahtomedi, MN
• Providers in Mahtomedi, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2009; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.