Raytown Dental PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

RAYTOWN DENTAL PLLC

Practice address

10208 E State Route 350
Raytown, MO 64138-1805

Phone

(816) 356-2476

NPI assigned

Apr 14, 2021

Last updated

Nov 8, 2023By 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

Creed Cardon

Title

Owner

Phone

(918) 998-0996

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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.

• Michael Woodhead, DMD

  • Dentist
  • Raytown, MO
  • NPI 1740832443
  NPD
• Will Argana, DDS

  • General Practice Dentistry
  • Omaha, NE
  • NPI 1003555038
  NPD
• Tyler Owens, DMD

  • Pediatric Dentistry
  • Webb City, MO
  • NPI 1609268861
  NPD (past)

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

{
    "created_epoch": "1618358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699401600000",
    "number": "1205416047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 RIVERWALK TER STE 250",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740375619",
            "telephone_number": "918-998-0996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10208 E STATE ROUTE 350",
            "city": "RAYTOWN",
            "state": "MO",
            "postal_code": "641381805",
            "telephone_number": "816-356-2476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAYTOWN DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-14",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A",
        "authorized_official_last_name": "CARDON",
        "authorized_official_first_name": "CREED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-998-0996"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Radiance Health & Wellness Clinic Mo-KS (Radiance Health & Wellness)
• Jennifer Ramaeker, MS, CCC-SLP
• Melanie Alexis Ramos-Green, MA
• Raytown Dental (Comfort Dental Raytown)
• Raytown Dental LLC (Comfort Dental Raytown)
• Raytown Dentist, LLC
• Raytown Health Care LLC (Autumn Terrace Health & Rehabilitation)
• Raytown Opco LLC (Trustwell Living of Raytown)
• Raytown Road Healthcare LLC (Alpine Breeze Health and Wellness)
• Reaching Out

• Dentist in Raytown, MO
• Providers in Raytown, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; 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.