NPIMap

Organization Active NPI

Kirtley & Stuckwisch, LLC

  • General Practice Dentistry
  • Seymour, IN
National Provider Identifier
1972613339
Registry record updated Jan 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12008976A Issued in IN
Legal business name
KIRTLEY & STUCKWISCH, LLC
Practice address
325 N Walnut St
Suite a
Seymour, IN 47274-2113
Phone
(812) 522-1899
Fax
(812) 522-2759
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2014

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

Authorized official

Name
Dr. William Richard Kirtley, DDSNPI 1447266309
Title
Member
Phone
(812) 522-1899

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 12008976A IN Primary

Addresses

Primary practice location

325 N Walnut St
Suite a
Seymour, IN 47274-2113

Mailing address

325 N Walnut St
Suite a
Seymour, IN 47274-2113
Phone (812) 522-1899

Other identifiers 1

IdentifierTypeStateIssuer
100140320MedicaidIN

National Provider Directory

National Provider Directory

Locations

325 N Walnut St
Ste A
Seymour, IN 47274
Phone (812) 522-1899

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390780800000",
    "number": "1972613339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 N WALNUT ST",
            "address_2": "SUITE A",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472742113",
            "telephone_number": "812-522-1899",
            "fax_number": "812-522-2759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N WALNUT ST",
            "address_2": "SUITE A",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472742113",
            "telephone_number": "812-522-1899",
            "fax_number": "812-522-2759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIRTLEY & STUCKWISCH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2014-01-27",
        "status": "A",
        "authorized_official_last_name": "KIRTLEY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "812-522-1899",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12008976A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100140320",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seymour, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2014; 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.