Pediatric Dental Specialists, PA

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

015672 Issued in MO

Legal business name

PEDIATRIC DENTAL SPECIALISTS, PA

Practice address

209 NE Barry Rd
Kansas City, MO 64155-2721

Phone

(816) 741-8881

Fax

(816) 741-0585

NPI assigned

Dec 23, 2009

Organization subpart

No

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

Authorized official

Name

Alice Webster

Title

Office Manager

Phone

(816) 741-8881

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1261526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261526400000",
    "number": "1083943963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 NE BARRY RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641552721",
            "telephone_number": "816-741-8881",
            "fax_number": "816-741-0585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 NE BARRY RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641552721",
            "telephone_number": "816-741-8881",
            "fax_number": "816-741-0585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTAL SPECIALISTS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-23",
        "last_updated": "2009-12-23",
        "status": "A",
        "authorized_official_last_name": "WEBSTER",
        "authorized_official_first_name": "ALICE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "816-741-8881"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MO",
            "license": "015672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Paul Pecoraro, MD
• Jodi L Pedersen, DC, BS
• Natalie Bliss Pederson, DPT
• Pediatric Care North
• Pediatric Care North
• Pediatric Group Inc
• Pediatric Headache Center PC
• Pediatric Smiles, LLC
• Pediatric Therapy Services, Inc.
• Pediatrix

• Dental Clinic/Center in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Dental Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2009; 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.