Individual provider Active NPI

Stephen Circello, DDS

  • General Practice Dentistry
  • Kansas City, MO
National Provider Identifier
1114941473
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
014258 Issued in MO
Practice address
7900 Lees Summit Rd
Kansas City, MO 64139-1236
Phone
(816) 404-6885
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 014258 MO Primary

Addresses

Primary practice location

7900 Lees Summit Rd
Kansas City, MO 64139-1236

Mailing address

7900 Lees Summit Rd
Kansas City, MO 64139-1236
Phone (816) 404-6885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20150610001557 MO Order and Referring Only - DentistPractitioner - Dentist 1355662701

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
014258MOMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114941473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 LEES SUMMIT RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641391236",
            "telephone_number": "816-404-6885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 LEES SUMMIT RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641391236",
            "telephone_number": "816-404-6885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIRCELLO",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "014258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.