Mark F Adams, DMD
Individual provider Active NPI Dentist · Arnold, MO
NPI 1003086737 · NPPES record last updated May 4, 2010
Key facts
- NPI
- 1003086737
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 2008003837 (MO)
- Practice address
- 1708 Missouri State Rd
Arnold, MO 63010-2006 - Phone
- (636) 287-9331
- NPI assigned
- Mar 10, 2008
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170406002288 | MO | Order and Referring Only - Dentist |
4284953415 |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2008003837 | MO | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thomas John Kennedy of Missouri, DDS, P.C. | Dentist | Past | Accepting new patients |
| Terry L. Brown, DMD, P.C. | Dentist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2008003837 | MO | Yes |
Addresses
Primary practice location
1708 Missouri State Rd
Arnold, MO 63010-2006
Mailing address
1708 Missouri State Rd
Arnold, MO 63010-2006
Phone (636) 287-9331
Other providers in Arnold, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 4, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.