Springfield Celebrate Pediatrics LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SPRINGFIELD CELEBRATE PEDIATRICS LLC

Practice address

4214 S Farm Road 135
Springfield, MO 65810-3716

Phone

(417) 289-0000

NPI assigned

Mar 19, 2024

Last updated

Mar 19, 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

Mike Melanson, DMD

Title

Owner

Phone

(417) 289-0000

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710806400000",
    "number": "1184483216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4214 S FARM ROAD 135",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658103716",
            "telephone_number": "417-289-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4214 S FARM ROAD 135",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658103716",
            "telephone_number": "417-289-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRINGFIELD CELEBRATE PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A",
        "authorized_official_last_name": "MELANSON",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-289-0000",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Springfield Dentistry 4 Kids LLC (Springfield Dentistry 4 Kids)
• Springfield Ear Nose Throat & Facial Plastic Surgery
• Springfield Eye & Plastic Surgery
• Springfield Eye Specialists LLC

• Dental Clinic/Center in Springfield, MO
• Providers in Springfield, 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 Mar 19, 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.