Ads Osage Beach LP

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

ADS OSAGE BEACH LP

Practice address

4320 Osage Beach Pkwy
Osage Beach, MO 65065-2199

Phone

(573) 348-1466

NPI assigned

Nov 20, 2023

Last updated

Nov 20, 2023By 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

Kari A Hicks

Title

Managing Director

Phone

(417) 501-1082

Specialties & licenses 1

Addresses

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.

• Philip Hyun Son, DMD

  • General Practice Dentistry
  • Osage Beach, MO
  • NPI 1124696083
  NPD

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

{
    "created_epoch": "1700438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700438400000",
    "number": "1144095100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2933",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658012933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 OSAGE BEACH PKWY",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650652199",
            "telephone_number": "573-348-1466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADS OSAGE BEACH LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-20",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "KARI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "417-501-1082"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Osage Beach, MO
• Providers in Osage Beach, 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 Nov 20, 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.