NPIMap

Organization Active NPI

St. Joseph Family Dental, LLC

  • General Practice Dentistry
  • Saint Joseph, MO
National Provider Identifier
1215864905
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ST. JOSEPH FAMILY DENTAL, LLC
Practice address
3904 Beck Rd Ste 110
Saint Joseph, MO 64506-5037
Phone
(816) 233-2672
Fax
(816) 233-4725
NPI assigned
May 6, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Authorized official

Name
Mrs. Kaitlyn Walters, DMDNPI 1457791386
Title
Owner
Phone
(816) 233-2672

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

3904 Beck Rd Ste 110
Saint Joseph, MO 64506-5037

Mailing address

3904 Beck Rd Ste 110
Saint Joseph, MO 64506-5037
Phone (816) 233-2672

National Provider Directory

National Provider Directory
Tax ID family
St Joseph Family Dental LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 3

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": "1778025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778630400000",
    "number": "1215864905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3904 BECK RD STE 110",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645065037",
            "telephone_number": "816-233-2672",
            "fax_number": "816-233-4725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3904 BECK RD STE 110",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645065037",
            "telephone_number": "816-233-2672",
            "fax_number": "816-233-4725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH FAMILY DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-06",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "KAITLYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "816-233-2672",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "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 May 13, 2026; 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.