Lon Roland Tracy, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

14713 Issued in MO

Practice address

300 S. Independence Street
Harrisonville, MO 64701

Phone

(816) 380-6000

Fax

(816) 380-6000

NPI assigned

Feb 20, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1361318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528156800000",
    "number": "1073853586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 549",
            "city": "HARRISONVILLE",
            "state": "MO",
            "postal_code": "64701",
            "telephone_number": "816-380-6000",
            "fax_number": "816-380-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S. INDEPENDENCE STREET",
            "city": "HARRISONVILLE",
            "state": "MO",
            "postal_code": "64701",
            "telephone_number": "816-380-6000",
            "fax_number": "816-380-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRACY",
        "first_name": "LON",
        "middle_name": "ROLAND",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-20",
        "last_updated": "2018-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "014713",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "14713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Harrisonville, MO
• Providers in Harrisonville, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.