Individual provider Active NPI

Guerschon De Laurent, DDS

  • General Practice Dentistry
  • North Kansas City, MO
National Provider Identifier
1013959717
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
024125 Issued in MO
Practice address
2328 Armour Road
North Kansas City, MO 64116
Phone
(816) 472-5660
Fax
(816) 472-5685
NPI assigned
Jun 10, 2006
Last updated
Jun 21, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 024125 MO Primary

Addresses

Primary practice location

2328 Armour Road
North Kansas City, MO 64116

Mailing address

2328 Armour Road
Norht Kansas City, MO 64116
Phone (816) 472-5660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
024125MOMDGeneral Practice Dentistry

Networks

  • devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
  • IA HMO C-SNP

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1013959717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2328 ARMOUR ROAD",
            "city": "NORHT KANSAS CITY",
            "state": "MO",
            "postal_code": "64116",
            "telephone_number": "816-472-5660",
            "fax_number": "816-472-5685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2328 ARMOUR ROAD",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "64116",
            "telephone_number": "816-472-5660",
            "fax_number": "816-472-5685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LAURENT",
        "first_name": "GUERSCHON",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "024125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; 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.