Individual provider Active NPI

Jariya Niyakorn DO, DDS

  • General Practice Dentistry
  • Kansas City, MO
National Provider Identifier
1073558482
Registry record updated Jul 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2004016378 Issued in MO
Practice address
7900 Lees Summit Rd
Kansas City, MO 64139-1236
Phone
(816) 404-6885
Fax
(816) 404-6903
NPI assigned
Jun 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2015

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 2004016378 MO Primary

Addresses

Primary practice location

7900 Lees Summit Rd
Kansas City, MO 64139-1236

Mailing address

7900 Lees Summit Rd
Kansas City, MO 64139-1236
Phone (816) 404-6885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150806010281 MO Order and Referring Only - DentistPractitioner - Dentist 6406177849

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2004016378MOMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437091200000",
    "number": "1073558482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 LEES SUMMIT RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641391236",
            "telephone_number": "816-404-6885",
            "fax_number": "816-404-6903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 LEES SUMMIT RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641391236",
            "telephone_number": "816-404-6885",
            "fax_number": "816-404-6903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIYAKORN DO",
        "first_name": "JARIYA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-19",
        "last_updated": "2015-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2004016378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.