Organization Active NPI

Michael S. Todd D.M.D., LLC

  • General Practice Dentistry
  • Columbia, MO
National Provider Identifier
1053568865
Registry record updated Aug 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
015815 Issued in MO
Legal business name
MICHAEL S. TODD D.M.D., LLC
Practice address
1500 Vandiver Dr
Suite 104
Columbia, MO 65202-3932
Phone
(573) 814-1694
Fax
(573) 814-2845
NPI assigned
Aug 22, 2008
Last updated
Aug 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2008

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

Authorized official

Name
Miss Kerri L Smith
Title
Office Manager
Phone
(573) 814-1694

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 015815 MO Primary

Addresses

Primary practice location

1500 Vandiver Dr
Suite 104
Columbia, MO 65202-3932

Mailing address

1500 Vandiver Dr
Suite 104
Columbia, MO 65202-3932
Phone (573) 814-1694

National Provider Directory

National Provider Directory

Locations

1500 Vandiver Dr
Ste 104
Columbia, MO 65202
Phone (573) 814-1694

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1219363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219363200000",
    "number": "1053568865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 VANDIVER DR",
            "address_2": "SUITE 104",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652023932",
            "telephone_number": "573-814-1694",
            "fax_number": "573-814-2845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 VANDIVER DR",
            "address_2": "SUITE 104",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652023932",
            "telephone_number": "573-814-1694",
            "fax_number": "573-814-2845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL S. TODD D.M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-22",
        "last_updated": "2008-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KERRI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "573-814-1694",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "015815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2008; 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.