Amanda Katherine Cummings, DDS
Individual provider Active NPI General Practice Dentistry · Richland, MO
NPI 1174215313 · NPPES record last updated May 25, 2023
Key facts
- NPI
- 1174215313
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 2023019106 (MO)
- Practice address
- 304 W Washington Ave
Richland, MO 65556-7101 - Phone
- (573) 346-4446
- NPI assigned
- May 25, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Dentist
- Education
- University of North Carolina School of Dentistry, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1652 N Business Route 5
Camdenton, MO 65020-6872
326 S Mount Auburn Rd
Suite 201
Cape Girardeau, MO 63703-4907
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260217003723 | MO | Practitioner - Dentist | 0941780969 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2023019106 | MO | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Richland Medical Center, Inc. | Current |
Accepting new patients | |
| Richland Medical Center, Inc | Current |
Accepting new patients | |
| Richland Medical Center, Inc. | Past | Accepting new patients |
Locations
112 S Pine St
Eldon, MO 65026
Phone (573) 392-8000
401 N Main St
Gravois Mills, MO 65037
Phone (573) 374-0767
304 W Washington Ave
Richland, MO 65556
Phone (573) 765-5131
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2023019106 | MO | Yes |
Addresses
Primary practice location
304 W Washington Ave
Richland, MO 65556-7101
Mailing address
PO Box 777
Richland, MO 65556-0777
Phone (573) 765-5131
Other providers in Richland, MO
- Samantha Kay Belen
- Blessed Assurance Counseling, LLC
- Ellen Brown
- John Caudell Carson
- Earleen F Cashill
- Megan Davault
- Elizabeth C Ewers Teel
- Rachel Fenton
- Danielle Fowers
- Robert Jaaron Fowers
All providers in Richland, MO · General Practice Dentistry in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 25, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.