NPIMap

Individual provider Active NPI

Tiara Arianne Fry, DDS

  • General Practice Dentistry
  • Kansas City, KS
National Provider Identifier
1053048116
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
62011 Issued in KS
Practice address
10818 Parallel Pkwy
Kansas City, KS 66109-3649
Phone
(913) 299-8860
Fax
(913) 299-8880
NPI assigned
Aug 8, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 2022019287 MO
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 62011 KS Primary

Addresses

Primary practice location

10818 Parallel Pkwy
Kansas City, KS 66109-3649

Mailing address

8961 Metcalf Ave Apt 424
Overland Park, KS 66212-1500
Phone (314) 749-2238

Other identifiers 1

IdentifierTypeStateIssuer
1053048116MedicaidKS

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL Epic
CONNECT URL EPIC

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
62011KSMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Alex Sharifian DDS Madison Dental Group PC General Practice PastSince Aug 1, 2022 Accepting new patients
Legends Dental Group, P.a. General Practice PastSince Dec 6, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1053048116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8961 METCALF AVE APT 424",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662121500",
            "telephone_number": "314-749-2238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10818 PARALLEL PKWY",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661093649",
            "telephone_number": "913-299-8860",
            "fax_number": "913-299-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "TIARA",
        "middle_name": "ARIANNE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-08",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2022019287",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "62011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053048116",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Epic",
            "affiliation": "N",
            "address_1": "13541 Madison Ave",
            "city": "Kansas City",
            "state": "MO",
            "country_code": "US",
            "postal_code": "641451669",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "EPIC",
            "affiliation": "N",
            "endpointDescription": "EPIC",
            "address_1": "10818 Parallel Pkwy",
            "city": "Kansas City",
            "state": "KS",
            "country_code": "US",
            "postal_code": "661093649",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; 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.