NPIMap

Organization Active NPI

Core Family Dentistry LLC

  • General Practice Dentistry
  • Linn, MO
National Provider Identifier
1245765759
Registry record updated Apr 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2006016427 Issued in MO
Legal business name
CORE FAMILY DENTISTRY LLC
Practice address
1217 E Main St
Linn, MO 65051-9634
Phone
(573) 897-2388
NPI assigned
Apr 23, 2017
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Corey Mack, DDSNPI 1962541995
Title
Owner
Phone
(620) 240-0565

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

Practitioners 2

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

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 2006016427 MO Primary

Addresses

NPPES NPI Registry

Primary practice location

1217 E Main St
Linn, MO 65051-9634

Mailing address

1217 E Main St
Linn, MO 65051-9634
Phone (573) 897-2388

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 23, 2017.

{
    "created_epoch": "1492905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492905600000",
    "number": "1245765759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 E MAIN ST",
            "city": "LINN",
            "state": "MO",
            "postal_code": "650519634",
            "telephone_number": "573-897-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 E MAIN ST",
            "city": "LINN",
            "state": "MO",
            "postal_code": "650519634",
            "telephone_number": "573-897-2388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORE FAMILY DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-23",
        "last_updated": "2017-04-23",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "COREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "620-240-0565",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2006016427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Linn, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2017; 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.