Individual provider Active NPI

Meagan Lacie Rondeau, DDS

  • Dentist
  • Overland Park, KS
National Provider Identifier
1073804282
Registry record updated May 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
61072 Issued in KS
Practice address
6300 W 143Rd St
Suite 110
Overland Park, KS 66223-2907
Phone
(913) 338-3443
Fax
(913) 239-9488
NPI assigned
Apr 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 61072 KS Primary

Addresses

Primary practice location

6300 W 143Rd St
Suite 110
Overland Park, KS 66223-2907

Mailing address

6300 W 143Rd St
Suite 110
Overland Park, KS 66223-2907
Phone (913) 338-3443

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20150608002609 KS Order and Referring Only - DentistPractitioner - Dentist 9234450834

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61072KSMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
GPS BVS, LLC PastSince Oct 24, 2021 Accepting new patients

Organizations & group practices 1

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": "1303344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432857600000",
    "number": "1073804282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 W 143RD ST",
            "address_2": "SUITE 110",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662232907",
            "telephone_number": "913-338-3443",
            "fax_number": "913-239-9488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 W 143RD ST",
            "address_2": "SUITE 110",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662232907",
            "telephone_number": "913-338-3443",
            "fax_number": "913-239-9488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RONDEAU",
        "first_name": "MEAGAN",
        "middle_name": "LACIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-21",
        "last_updated": "2015-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KS",
            "license": "61072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.