Individual provider Active NPI

Ricardo Lemus

  • General Practice Dentistry
  • Joplin, MO
National Provider Identifier
1073928719
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2014018841 Issued in MO
Practice address
431 S Northpark LN
Joplin, MO 64801-8441
Phone
(713) 703-3296
NPI assigned
Jun 20, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 61273 KS
General Practice Dentistry 1223G0001X 2014018841 MO Primary

Addresses

Primary practice location

431 S Northpark LN
Joplin, MO 64801-8441

Mailing address

530 S Maiden LN
Joplin, MO 64801-3084
Phone (417) 782-6200

Other practice location 1

3011 N Michigan St
Pittsburg, KS 66762-2546
Phone (620) 231-9873

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
I20161117000685 KS Practitioner - DentistPractitioner - Oral Surgery 2961780440 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2014018841MOMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center of Southeast Kansas Inc CurrentSince Sep 24, 2024 Accepting new patients
Team Dental Inc General Practice Past Accepting new patients

Locations

2990 Military Ave
Baxter Springs, KS 66713
Phone (620) 856-2900

2100 Commerce Dr
Parsons, KS 67357
Phone (620) 421-2159

3011 N Michigan St
Pittsburg, KS 66762
Phone (620) 231-1960

Interoperability endpoints

  • Direct secure messaging: ricardo.lemus@chcsek.eclinicaldirectplus.com

Organizations & group practices 2

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": "1403222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1073928719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 S MAIDEN LN",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648013084",
            "telephone_number": "417-782-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 S NORTHPARK LN",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648018441",
            "telephone_number": "713-703-3296"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3011 N Michigan St",
            "address_purpose": "LOCATION",
            "city": "Pittsburg",
            "state": "KS",
            "postal_code": "667622546",
            "country_code": "US",
            "telephone_number": "620-231-9873",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEMUS",
        "first_name": "RICARDO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-20",
        "last_updated": "2021-01-15",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "61273",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2014018841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

Verify at the official NPI Registry.