NPIMap

Organization Active NPI

Overbrook Family Dentistry

  • Dentist
  • Overbrook, KS
National Provider Identifier
1174931430
Registry record updated Jul 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
OVERBROOK FAMILY DENTISTRY
Practice address
306 Maple St
Overbrook, KS 66524-9747
Phone
(785) 665-7311
Fax
(785) 665-7126
NPI assigned
Jul 30, 2014
Last updated
Jul 30, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2014

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

Authorized official

Name
Michael Shaw, DDS
Title
Owner
Phone
(785) 665-7311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X Primary

Addresses

Primary practice location

306 Maple St
Overbrook, KS 66524-9747

Mailing address

306 Maple St
Overbrook, KS 66524-9747
Phone (785) 665-7311

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1406678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406678400000",
    "number": "1174931430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 MAPLE ST",
            "city": "OVERBROOK",
            "state": "KS",
            "postal_code": "665249747",
            "telephone_number": "785-665-7311",
            "fax_number": "785-665-7126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 MAPLE ST",
            "city": "OVERBROOK",
            "state": "KS",
            "postal_code": "665249747",
            "telephone_number": "785-665-7311",
            "fax_number": "785-665-7126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OVERBROOK FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-30",
        "last_updated": "2014-07-30",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "785-665-7311",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overbrook, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2014; 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.