Kyle Detmer, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

61906 Issued in KS

Practice address

404 S Edgemoor St Ste 320
Wichita, KS 67218-1632

Phone

(316) 559-3993

NPI assigned

Jul 7, 2021

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1982275202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8930 W SUNCREST ST APT 603",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672124069",
            "telephone_number": "316-617-7184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 S EDGEMOOR ST STE 320",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672181632",
            "telephone_number": "316-559-3993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETMER",
        "first_name": "KYLE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-07",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "61906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desiree Hoetmer Lscsw, LLC
• Heather Louise Despain
• Alison N Despard, LSCSW
• Richard A Desplinter, MD
• Cara Lee Detmer, DDS
• Margaret Anne Detmer, DDS
• Wesley Scott Detrick, D.C.
• Soonhee P Detwiler
• Jeremy Deutsch, MD
• Suzanne R Devaughn, LMSW

• General Practice Dentistry in Wichita, KS
• Providers in Wichita, KS by specialty
• General Practice Dentistry in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; 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.