NPIMap

Organization Active NPI

Facial Surgery Group PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Kansas City, MO
National Provider Identifier
1194745620
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DE015905 Issued in MO
Legal business name
FACIAL SURGERY GROUP PC
Practice address
4700 Belleview
Ste L 10
Kansas City, MO 64112-1360
Phone
(816) 561-1115
Fax
(816) 931-7912
NPI assigned
Jul 20, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Louann Allen
Title
Practice Manager
Phone
(816) 561-1115

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DE015905 MO Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DE015216 MO

Addresses

Primary practice location

4700 Belleview
Ste L 10
Kansas City, MO 64112-1360

Mailing address

PO Box 802752
Kansas City, MO 64180-0001
Phone (816) 561-1115

Other identifiers 1

IdentifierTypeStateIssuer
27056013OtherMOBCBS OF KCMO

Other names 1

  • Tanner and Moore Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194745620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 802752",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641800001",
            "telephone_number": "816-561-1115",
            "fax_number": "816-753-4493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 BELLEVIEW",
            "address_2": "STE L 10",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641121360",
            "telephone_number": "816-561-1115",
            "fax_number": "816-931-7912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FACIAL SURGERY GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "LOUANN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "816-561-1115",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "DE015905",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "DE015216",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF KCMO",
            "identifier": "27056013",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tanner and Moore",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.