Arezo Hesaraki, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2014031462 Issued in MO

Practice address

2016 S Broadway
Oak Grove, MO 64075-8439

Phone

(816) 690-4141

NPI assigned

Oct 23, 2014

Last updated

Oct 2, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KS, MO2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FCJABA

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.

• Swope Health Services

  • Federally Qualified Health Center (FQHC)
  • Kansas City, MO
  • NPI 1689760076
  Medicare reassignment NPD
• Swope Health Services

  • Federally Qualified Health Center (FQHC)
  • Kansas City, KS
  • NPI 1861587511
  Medicare reassignment NPD
• Ridgeview Family Dental Oakgrove PLLC

  • Dental Clinic/Center
  • Oak Grove, MO
  • NPI 1124899364
  NPD
• Swope Health Services

  • Federally Qualified Health Center (FQHC)
  • Kansas City, MO
  • NPI 1285404434
  NPD
• Swope Health Services

  • Federally Qualified Health Center (FQHC)
  • Riverside, MO
  • NPI 1568557205
  NPD
• Swope Health Services

  • Federally Qualified Health Center (FQHC)
  • Kansas City, KS
  • NPI 1013002765
  NPD

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

{
    "created_epoch": "1414022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1174928857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 W 10TH ST",
            "address_2": "STE 480",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012905",
            "telephone_number": "816-690-4141"
        },
        {
            "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": {
        "last_name": "HESARAKI",
        "first_name": "AREZO",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-23",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2014031462",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "61113",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Shae Haedike-Swift, MA
• Evan Canton Hall
• John Thomas Haller, DC
• Shane Landon Hatfield, PHARM.D.
• Susan Y Hausheer, PT
• Lisa K Hudson
• Infinity One Mobile Labs LLC
• Pam J Jackson, RPH
• Ashley Lynn Keating, FNP-C
• Sarah Lynn Kostos, PT, DPT

• General Practice Dentistry in Oak Grove, MO
• Providers in Oak Grove, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.