Rebecca Johnson Kucera, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

3783 Issued in WV

Practice address

1489 N Jefferson St
Lewisburg, WV 24901-1187

Phone

(304) 645-0251

Fax

(304) 645-0252

NPI assigned

Jul 19, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316563200000",
    "number": "1922208867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1489 N JEFFERSON ST",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249011187",
            "telephone_number": "304-645-0251",
            "fax_number": "304-645-0252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1489 N JEFFERSON ST",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249011187",
            "telephone_number": "304-645-0251",
            "fax_number": "304-645-0252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCERA",
        "first_name": "REBECCA",
        "middle_name": "JOHNSON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-19",
        "last_updated": "2011-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WV",
            "license": "3783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "800340665",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810006780",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF WV DENTAL LICENS",
            "identifier": "3783",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debra King
• Linda King, M.S., CCC-SLP
• Hanno W Kirk, LICSW, PHD
• Gary L Knepp, DO
• Carma J Korman, MSW
• Maple T. Landvoigt, MD
• David L Lanier
• Mary C Laumb
• Leaseburge Chiropractic, Inc.
• Susan Meadows Leatherman, MPT

• Pediatric Dentistry in Lewisburg, WV
• Providers in Lewisburg, WV by specialty
• Pediatric Dentistry in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; 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.