Individual provider Active NPI

Jonathan Ehlers, D.D.S.

  • Dentist
  • Westphalia, MO
National Provider Identifier
1114247046
Registry record updated Mar 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2010016134 Issued in MO
Practice address
1875 Highway 63
Westphalia, MO 65085-2215
Phone
(573) 455-2710
Fax
(573) 455-2705
NPI assigned
Jun 2, 2010
Last updated
Mar 4, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2010016134 MO Primary

Addresses

Primary practice location

1875 Highway 63
Westphalia, MO 65085-2215

Mailing address

1875 Highway 63
Westphalia, MO 65085-2215
Phone (573) 455-2710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jonathan R Ehlers DDS PC PastSince Oct 24, 2016 Accepting new patients
University Health Physicians Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425427200000",
    "number": "1114247046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 HIGHWAY 63",
            "city": "WESTPHALIA",
            "state": "MO",
            "postal_code": "650852215",
            "telephone_number": "573-455-2710",
            "fax_number": "573-455-2705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 HIGHWAY 63",
            "city": "WESTPHALIA",
            "state": "MO",
            "postal_code": "650852215",
            "telephone_number": "573-455-2710",
            "fax_number": "573-455-2705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHLERS",
        "first_name": "JONATHAN",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-02",
        "last_updated": "2015-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2010016134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westphalia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2015; 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.