NPIMap

Organization Active NPI

Midwestperiodontics

  • Periodontics
  • Saint Joseph, MO
National Provider Identifier
1194191213
Registry record updated Aug 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
14401 Issued in MO
Legal business name
MIDWESTPERIODONTICS
Practice address
1006 W Saint Maartens Dr
Suite a
Saint Joseph, MO 64506-2966
Phone
(816) 364-3325
NPI assigned
Aug 12, 2015
Last updated
Aug 12, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2015

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

Authorized official

Name
Dr. Steve Southard, DDS
Title
President
Phone
(816) 390-2500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 14401 MO Primary

Addresses

Primary practice location

1006 W Saint Maartens Dr
Suite a
Saint Joseph, MO 64506-2966

Mailing address

1006 W Saint Maartens Dr
Suite a
Saint Joseph, MO 64506-2966
Phone (816) 364-3325

National Provider Directory

National Provider Directory

Locations

1006 W Saint Maartens Dr
Ste A
Saint Joseph, MO 64506
Phone (816) 364-3325

NPI Registry JSON

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

{
    "created_epoch": "1439337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439337600000",
    "number": "1194191213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 W SAINT MAARTENS DR",
            "address_2": "SUITE A",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062966",
            "telephone_number": "816-364-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 W SAINT MAARTENS DR",
            "address_2": "SUITE A",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062966",
            "telephone_number": "816-364-3325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWESTPERIODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-12",
        "last_updated": "2015-08-12",
        "status": "A",
        "authorized_official_last_name": "SOUTHARD",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "816-390-2500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MO",
            "license": "14401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2015; 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.