Kahoka Dental – Public Health Dentistry, NPI 1457634594

Kahoka Dental is a healthcare provider. based in Kahoka, Missouri. specializing in Public Health Dentistry. The organization holds a License No. 2007014537 (MO). The NPI Number for Kahoka Dental is 1457634594

Main info

Organization
Name
Kahoka Dental
NPI
1457634594
Phone
(660) 727-1500
Address
248 N MORGAN ST
Authorized Official
ANDREW GRIMM EXECUTIVE DIRECTOR
Enumeration Date
26 September 2011
Last Update Date
17 January 2022
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness80
Years active:14State licenses:1Digital endpointsUpdated within 12 months

Provider Addresses for Kahoka Dental

  • 248 N MORGAN ST

    KAHOKA, MO 634451433

    Phone: (660) 727-1500

    Fax: (660) 727-1502

    Type: Location

  • 1416 CROWN DR

    KIRKSVILLE, MO 635012548

    Phone: (660) 627-5757

    Fax: (660) 627-5802

    Type: Mailing

  • 22291 US HIGHWAY 136

    KAHOKA, MO 63445

    Phone: (660) 727-1500

    Fax: (660) 727-1502

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-08-24

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-01-31 (866 days ago).

Enrollment records

1

Earliest due date

2024-01-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20170824002340OFederally Qualified Health Center (Fqhc)MO2024-01-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 63445)

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Reviews

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Frequently asked questions

What is the registry number for Kahoka Dental?
The registry entry for Kahoka Dental shows NPI 1457634594.
Quick check: is Kahoka Dental active?
Public NPPES data shows Kahoka Dental with an active NPI status right now.
What type of care does Kahoka Dental provide?
Kahoka Dental's profile centers on Public Health Dentistry. Clinical services aligned with this taxonomy classification.
What city is tied to Kahoka Dental?
The directory associates Kahoka Dental with Kahoka, Missouri. Check all listed addresses for suites or satellite offices.
Who maintains Kahoka Dental's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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