Ridgeview Family Dental Oakgrove PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

RIDGEVIEW FAMILY DENTAL OAKGROVE PLLC

Practice address

2016 S Broadway
Oak Grove, MO 64075-8439

Phone

(816) 690-4141

NPI assigned

Jan 15, 2024

Last updated

Jan 15, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Creed Cardon

Title

Owner

Phone

(918) 998-0996

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Arezo Hesaraki, DDS

  • General Practice Dentistry
  • Oak Grove, MO
  • NPI 1174928857
  NPD

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

{
    "created_epoch": "1705276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705276800000",
    "number": "1124899364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 RIVERWALK TER STE 250",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740375619",
            "telephone_number": "918-998-0996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2016 S BROADWAY",
            "city": "OAK GROVE",
            "state": "MO",
            "postal_code": "640758439",
            "telephone_number": "816-690-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGEVIEW FAMILY DENTAL OAKGROVE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-15",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A",
        "authorized_official_last_name": "CARDON",
        "authorized_official_first_name": "CREED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-998-0996"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patriot Rehabilitation, LLC
• R W Consultant
• Red Cross Pharmacy, Inc.
• Brooke Reed, DPT
• Rehabcare Inc
• Rebecca Rowe
• Kumba Emma Kamayah Saquee
• Serc Rehabilitation Partners LLC (SERC - Oak Grove, MO)
• Mandy Kay Shores
• Cristy Skaggs, RN

• Dental Clinic/Center in Oak Grove, MO
• Providers in Oak Grove, 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 Jan 15, 2024; 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.