NPIMap

Organization Active NPI

Overland Park Modern Dentistry PA

  • General Practice Dentistry
  • Overland Park, KS
National Provider Identifier
1215367172
Registry record updated Nov 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
OVERLAND PARK MODERN DENTISTRY PA
Practice address
13316 Metcalf Ave
Overland Park, KS 66213-2804
Phone
(913) 851-5110
Fax
(913) 851-0321
NPI assigned
Nov 13, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2013

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

Authorized official

Name
Dr. Matthew H Yip, DDS
Title
Owner
Phone
(913) 851-5110

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

13316 Metcalf Ave
Overland Park, KS 66213-2804

Mailing address

17000 Red Hill Ave
Irvine, CA 92614-5626
Phone (714) 845-8890

Other names 1

  • Overland Park Modern Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

13316 Metcalf Ave
Overland Park, KS 66213
Phone (913) 851-5110

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1384300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384300800000",
    "number": "1215367172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13316 METCALF AVE",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662132804",
            "telephone_number": "913-851-5110",
            "fax_number": "913-851-0321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OVERLAND PARK MODERN DENTISTRY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-13",
        "last_updated": "2013-11-13",
        "status": "A",
        "authorized_official_last_name": "YIP",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "913-851-5110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Overland Park Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2013; 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.