Steven Boyd Kottke, DDS
Individual provider Active NPI General Practice Dentistry · Carlton, MN
NPI 1780744136 · NPPES record last updated Jul 15, 2024
Key facts
- NPI
- 1780744136
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- D11988 (MN)
- Practice address
- 210 3Rd St
Carlton, MN 55718-7703 - Phone
- (218) 336-3524
- Fax
- (218) 384-9002
- NPI assigned
- Dec 8, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D11988 | MN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Superior Dental Associates | General Practice | Past |
Accepting new patients |
| Sla Dental PLLC | General Practice | Past | Accepting new patients |
Interoperability endpoints
- skottke814016@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D11988 | MN | Yes |
| General Practice Dentistry | 1223G0001X | 7143-15 | WI |
Addresses
Primary practice location
210 3Rd St
Carlton, MN 55718-7703
Mailing address
2222 E 5TH St
Superior, WI 54880-3709
Phone (715) 394-5411
Other practice location 1
2222 E 5th St
Superior, WI 54880-3709
Phone (715) 395-5389
Other practice location 2
4325 Grand Ave
Duluth, MN 55807-2730
Phone (218) 628-7035
Other providers in Carlton, MN
- Community Addiction Recovery Enterprise Carlton
- Inter-Faith Care Center
- Inter-Faith Care Center
- Kristen Marie Jaster
- Kirsten K Komarek
- Kimberly Kroll
- Lake Superior Community Health Center
- Cristy Sue Leonard-Rivers
- Gina Mott
- Linda Newlon
All providers in Carlton, MN · General Practice Dentistry in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.