Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kyle S Ettinger, DDS

Individual provider Dentist · NPI 1881989234

Kyle S Ettinger, DDS is a Maxillofacial Surgery in Rochester, Minnesota. Graduated from Mayo Medical School in 2014, 12 years ago. Practices with Mayo Clinic, a 4,796-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
12
Trained at
Mayo Medical School
Licensed in
MN
In the registry since
2011
Specialties on file
3
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

200 1st St SW
Rochester, MN 55905-0001
Phone: (507) 284-2511
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral & Maxillofacial Surgery (D.M.D.) (primary) Taxonomy 204E00000X · Licence 59378 (MN)
Dentist Taxonomy 122300000X · Licence D13023 (MN)
Oral & Maxillofacial Surgery (D.M.D.) Taxonomy 204E00000X · Licence D13023 (MN)

Record details

NPI number1881989234
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedJune 14, 2011
Last updated in NPPESAugust 13, 2020
Certification dateAugust 13, 2020
Mailing address200 1st St Sw, Rochester, MN 55905-0001

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMAXILLOFACIAL SURGERY
Medical schoolMAYO MEDICAL SCHOOL
Graduated 2014 (12 years in practice)
Group practice Mayo Clinic — 4796 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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