Organization Active NPI

Vaughn Family Dental

  • Dental Clinic/Center
  • Independence, MO
National Provider Identifier
1083300933
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
VAUGHN FAMILY DENTAL
Practice address
4437 S River Blvd Ste 110
Independence, MO 64055-4660
Phone
(816) 350-9988
NPI assigned
Apr 13, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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

Authorized official

Name
Jessica L Vaughn, DDSNPI 1588004378
Title
Owner
Phone
(314) 229-1615

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

4437 S River Blvd Ste 110
Independence, MO 64055-4660

Mailing address

4437 S River Blvd Ste 110
Independence, MO 64055-4660
Phone (816) 350-9988

National Provider Directory

National Provider Directory

Locations

4437 S River Blvd
Ste 110
Independence, MO 64055
Phone (816) 350-0400

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1681344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681344000000",
    "number": "1083300933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4437 S RIVER BLVD STE 110",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640554660",
            "telephone_number": "816-350-9988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4437 S RIVER BLVD STE 110",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640554660",
            "telephone_number": "816-350-9988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAUGHN FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-13",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A",
        "authorized_official_last_name": "VAUGHN",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-229-1615",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; 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.