DR. JACOB KEVIN BUTLER D.M.D., M.S. - NPI 1891136370

Q: What is Jacob Butler's NPI number?

The NPI number for Jacob Butler is 1891136370. It was assigned to this individual provider in the NPPES registry on July 11, 2013.

Q: What is Jacob Butler's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Endodontics, with taxonomy code 1223E0200X.

Q: Is Jacob Butler enrolled in Medicare?

No. Jacob Butler has opted out of Medicare through September 11, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Jacob Butler was last updated on November 16, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Dr. Jacob Kevin Butler D.m.d., M.s. NPPES

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

DR. JACOB KEVIN BUTLER D.M.D., M.S. (NPI 1891136370) is an individual endodontics provider in Wichita, Kansas, licensed in Kansas (61309) and active in the NPI registry since July 2013. He has opted out of Medicare through September 11, 2026.

NPPES Registry Identity

NPI1891136370

Entity TypeIndividualMale

Primary Taxonomy1223E0200X

Provider Legal NameDR. JACOB KEVIN BUTLERCredential: D.M.D., M.S.

Location Address12219 E CENTRAL AVEWichita, KS 67206-2808

Mailing Address12219 E Central AveWichita, KS 67206-2808 · (316) 681-1099 · Fax (316) 613-2417

Phone(316) 681-1099

Fax(316) 613-2417

Sole ProprietorNo

Enumeration DateJuly 11, 2013

Last NPPES UpdateNovember 16, 2022

NPPES CertifiedNovember 16, 2022

✔ NPI 1891136370 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · EndodonticsDental Providers

Taxonomy Code1223E0200X

License✔ Licensed in KS · 61309

Definition

The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.

12219 E CENTRAL AVE, Wichita, KS 67206

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Kansas, Inc., Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

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Opted out of Medicare

Dr. Jacob Kevin Butler D.m.d., M.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 September 11, 2018 through September 11, 2026.

Opt-Out Effective DateSeptember 11, 2018

Opt-Out In Effect ThroughSeptember 11, 2026Opt-out affidavits renew automatically every two years unless cancelled

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