1. Home
  2. Directory
  3. Kansas
  4. Wichita
  5. Dentist
  6. NPI Profile

DR. TERRA SHIVON PAULY D.D.S.
NPI 1407087851
Dentist in Wichita, KS

Active since August 03, 2009Opted out of Medicare · through Oct 12, 2027
4620 E DOUGLAS AVE STE 100, WICHITA, KS 67208(316) 263-0889 Get Directions Write a Review

NPPES record last updated: July 27, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Terra Shivon Pauly D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. TERRA SHIVON PAULY D.D.S. (NPI 1407087851) is an individual dentist in Wichita, Kansas, licensed in Kansas (60618) and active in the NPI registry since August 2009. She has opted out of Medicare through October 12, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1407087851
Entity TypeIndividualFemale
Primary Taxonomy122300000X
Provider Legal NameDR. TERRA SHIVON PAULYCredential: D.D.S.
Location Address4620 E DOUGLAS AVE STE 100Wichita, KS 67208-3955
Mailing Address4620 E Douglas Ave Ste 100Wichita, KS 67208-3955 · (316) 263-0889
Phone(316) 263-0889
Sole ProprietorNo
Enumeration DateAugust 3, 2009
Last NPPES UpdateJuly 27, 2020
NPPES CertifiedJuly 27, 2020
✔ NPI 1407087851 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in KS · 60618
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
4620 E DOUGLAS AVE STE 100, Wichita, KS 67208
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Terra Shivon Pauly D.d.s. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 12, 2015 through October 12, 2027.

Opt-Out Effective DateOctober 12, 2015
Opt-Out In Effect ThroughOctober 12, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 67208 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.98 typical visit price
range $53.00 – $161.67
Typical copayment $20.49 (range $13.25 – $40.41)
Most-billed visit code 99203
Established Patient
$66.40 typical visit price
range $16.88 – $132.11
Typical copayment $16.60 (range $4.22 – $33.02)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Terra Pauly's NPI number?

The NPI number for Terra Pauly is 1407087851. It was assigned to this individual provider in the NPPES registry on August 3, 2009.

Where is Terra Pauly located?

Terra Pauly practices at 4620 E Douglas Ave Ste 100, Wichita, KS 67208. The listed phone number is (316) 263-0889.

What is Terra Pauly's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Terra Pauly enrolled in Medicare?

No. Terra Pauly has opted out of Medicare through October 12, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Terra Pauly was last updated on July 27, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.