Braeden Mathur, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

PENDING Issued in MO

Practice address

821 Westwood Dr
Sedalia, MO 65301-2102

Phone

(660) 826-4774

NPI assigned

Jul 10, 2024

Last updated

Jan 8, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Regional Health Care Clinic Inc

  dba Katy Trail Community Health

  • Federally Qualified Health Center (FQHC)
  • Sedalia, MO
  • NPI 1922057504
  Medicare reassignment NPD
• Regional Health Care Clinic Inc

  dba Katy Trail Community Health Warsaw

  • Federally Qualified Health Center (FQHC)
  • Warsaw, MO
  • NPI 1053533539
  NPD
• Regional Health Care Clinic, Inc

  dba Katy Trail - Warsaw School

  • Federally Qualified Health Center (FQHC)
  • Warsaw, MO
  • NPI 1629797196
  NPD

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

{
    "created_epoch": "1720569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1205673977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 W MAIN ST",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653013821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 WESTWOOD DR",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653012102",
            "telephone_number": "660-826-4774"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17571 N Dam Access Rd",
            "address_purpose": "LOCATION",
            "city": "Warsaw",
            "state": "MO",
            "postal_code": "653556396",
            "country_code": "US",
            "telephone_number": "660-438-2717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHUR",
        "first_name": "BRAEDEN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-10",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marsha Jane Kranichfield (LifeSupport Interventions)
• Martin Group Care Home
• Joann Martin, APRN, CPNP
• Tiffany Suzanne Martin, L.C.S.W.
• Kayla Lorynn Mather, CNP
• Casey Eisenhower McCluskie, DC
• Maureen Ann McConnell, PT
• Frances H McKee, APRN, FNP-C
• Patricia Kay McKinney
• McWhirt-Gibson Incorporation (Medical Center Pharmacy)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.