Andrew J. Mettman, D.D.S.
Individual provider Active NPI General Practice Dentistry · Newton, KS
NPI 1982010229 · NPPES record last updated Feb 9, 2022
Key facts
- NPI
- 1982010229
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 61150 (KS)
- Practice address
- 606 N Main St Ste 102
Newton, KS 67114-2219 - Phone
- (316) 283-0110
- Fax
- (316) 283-0736
- NPI assigned
- Jul 8, 2014
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220330000334 | KS | Practitioner - Dentist | 4082913884 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 316 Family Dental LLC | General Practice | Current |
Accepting new patients |
| Glade Modern Dentistry and Orthodontics, PC | Past | Accepting new patients | |
| Cottonwood Dental Maize, PA | General Practice | Past |
Accepting new patients |
Locations
606 N Main St
Ste 102
Newton, KS 67114
Phone (316) 283-0110
171 S Maize Rd
Wichita, KS 67209
Phone (316) 721-2010
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 30025 | TX | |
| General Practice Dentistry | 1223G0001X | 61150 | KS | Yes |
Addresses
Primary practice location
606 N Main St Ste 102
Newton, KS 67114-2219
Mailing address
606 N Main St Ste 102
Newton, KS 67114-2219
Phone (316) 283-0110
Other providers in Newton, KS
- Carolyn Jane McNeill
- Susan E Meacham
- Joseph Michel Meier
- Courtney Nicole Mellinger
- Beverly Metcalf
- Randy Stephen Metzler
- Jeraka Lyndsy Michael
- Katherine Ann Mick
- Keri Annette Mick
- Midwest Corporate Air Care LLC
All providers in Newton, KS · General Practice Dentistry in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 9, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.