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NPI Code Detail

MEDICARE: KURT GEISEL DDS

MEDICARE: KURT GEISEL DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist5669AZ

General Provider Information

NPI Number : 1497167134
Entity Type Code : Individual
Provider Name (Legal Business Name) : KURT GEISEL DDS
Provider Business Mailing Address
First Line : 1420 N ROCKRIDGE RD
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86001-1148
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4212 N 16TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85016-5319
Country : US
Telephone Number : 602-263-1200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2014
Last Update Date : 06/13/2026

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Directions to “ KURT GEISEL DDS” Practice Location

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