Austin John Kottke, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D15071 Issued in MN

Practice address

1970 Buerkle Rd
White Bear Lake, MN 55110-1300

Phone

(651) 337-5695

NPI assigned

Jun 3, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• White Bear Dentists, PC

  • General Practice Dentistry
  • White Bear Lake, MN
  • NPI 1558725598
  NPD (past)

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1811738016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2428 DELAWARE ST SE APT 409",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554143829",
            "telephone_number": "952-688-2506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 BUERKLE RD",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551101300",
            "telephone_number": "651-337-5695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTTKE",
        "first_name": "AUSTIN",
        "middle_name": "JOHN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D15071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Klein, LCMT
• Kathleen A Kobbermann, MD
• Tyler J Koivisto, DDS
• Alexis Koller
• Roger K Koopman, PA
• Julie Kraai, LAMFT
• Jami Lee Kramb Wiles
• Madison Lynne Kreuser, PHARMD, RPH
• Anthony Kroll, CPT, LMT, ERS
• Dana Kromar, CNP

• Dentist in White Bear Lake, MN
• Providers in White Bear Lake, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.