Katherine Renee Snodgrass, DDS
Individual provider Active NPI Public Health Dentistry · Buckner, MO
NPI 1063940294 · NPPES record last updated Jun 1, 2017
Key facts
- NPI
- 1063940294
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Public Health Dentistry 1223D0001X
- License
- 2017016415 (MO)
- Practice address
- 324 S Hudson St
Buckner, MO 64016-8142 - Phone
- (816) 249-1521
- NPI assigned
- Jun 1, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170719004047 | MO | Order and Referring Only - Dentist |
7517237860 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2017016415 | MO | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| HCC Network | Past | Accepting new patients | |
| HCC Network | Past | Accepting new patients | |
| HCC Network | Past | Accepting new patients | |
| HCC Network | Past | Accepting new patients | |
| HCC Network | Past | Accepting new patients |
Interoperability endpoints
- katherine.snodgrass@hccnet.eclinicaldirectplus.com
- https://fhir4.healow.com/fhir/r4/JGBBCA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health Dentistry | 1223D0001X | 2017016415 | MO | Yes |
Addresses
Primary practice location
324 S Hudson St
Buckner, MO 64016-8142
Mailing address
4117 NE Edgewater CT
Lees Summit, MO 64064-3101
Phone (816) 591-8447
Other names
- Katherine Renee Heriford
Other providers in Buckner, MO
All providers in Buckner, MO · Public Health Dentistry in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 1, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.