Odessa Family Dental, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ODESSA FAMILY DENTAL, LLC

Practice address

404 N 4TH St
Odessa, MO 64076-1152

Phone

(816) 633-5393

NPI assigned

Oct 1, 2025

Last updated

Oct 1, 2025By 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

Chad Hendricks

Title

Credentialing

Phone

(612) 859-0444

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jerry L Haney, DDS

  • Dentist
  • Odessa, MO
  • NPI 1609863646
  NPD (past)

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

{
    "created_epoch": "1759276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759276800000",
    "number": "1013881101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 N 4TH ST",
            "city": "ODESSA",
            "state": "MO",
            "postal_code": "640761152",
            "telephone_number": "816-633-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 N 4TH ST",
            "city": "ODESSA",
            "state": "MO",
            "postal_code": "640761152",
            "telephone_number": "816-633-5393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODESSA FAMILY DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-01",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "612-859-0444"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• N & R of Odessa LLC (New Haven Living Center)
• Sarah Yaffa Naon, DMD
• Kristy Elaine Neville, RDN.LD
• Odessa Chiropractic Center
• Odessa Eye Care LLC
• Odessa Family Pharmacy
• Odessa Fire & Rescue Protection District
• Odessa Health Care Center, L.L.C. (Odessa Health Care Center)
• Odessa Medical Clinic, PC (Bradley L Zink DO)
• Odessa Pediatric Dental Care (Treetop Pediatric Dentistry Odessa)

• General Practice Dentistry in Odessa, MO
• Providers in Odessa, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2025; 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.