Michael L Edgar DDS PC

Primary specialty

DentistTaxonomy code 122300000X

License

014114 Issued in MO

Legal business name

MICHAEL L EDGAR DDS PC

Practice address

919 E Main St
Park Hills, MO 63601-2717

Phone

(573) 431-5566

Fax

(573) 431-3345

NPI assigned

Dec 28, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Michael L Edgar, DDS

Title

President

Phone

(573) 431-5566

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013073618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 E MAIN ST",
            "city": "PARK HILLS",
            "state": "MO",
            "postal_code": "636012717",
            "telephone_number": "573-431-5566",
            "fax_number": "573-431-3345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 E MAIN ST",
            "city": "PARK HILLS",
            "state": "MO",
            "postal_code": "636012717",
            "telephone_number": "573-431-5566",
            "fax_number": "573-431-3345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL L EDGAR DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EDGAR",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-431-5566",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MO",
            "license": "014114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.