Individual provider Active NPI

Michael Francis Poppa, DDS

  • General Practice Dentistry
  • Kansas City, MO
National Provider Identifier
1053894964
Registry record updated Sep 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2018032268 Issued in MO
Practice address
411 Nichols Rd Ste 231
Kansas City, MO 64112-2015
Phone
(816) 531-3439
NPI assigned
Sep 7, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2018

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 2018032268 MO Primary

Addresses

Primary practice location

411 Nichols Rd Ste 231
Kansas City, MO 64112-2015

Mailing address

7612 NE 86TH St
Kansas City, MO 64157-9542
Phone (816) 213-7696

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
2018032268MOMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1536278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1053894964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7612 NE 86TH ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641579542",
            "telephone_number": "816-213-7696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 NICHOLS RD STE 231",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641122015",
            "telephone_number": "816-531-3439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPPA",
        "first_name": "MICHAEL",
        "middle_name": "FRANCIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-07",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2018032268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2018; 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.