Edward B. Brobst, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

014353 Issued in MO

Practice address

6261 N. Oak Trafficway
Gladstone, MO 64118

Phone

(816) 413-8285

Fax

(816) 413-8662

NPI assigned

Jul 12, 2006

Last updated

Aug 19, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

State licenses

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219104000000",
    "number": "1265467666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6261 N. OAK TRAFFICWAY",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "64118",
            "telephone_number": "816-413-8285",
            "fax_number": "816-413-8662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6261 N. OAK TRAFFICWAY",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "64118",
            "telephone_number": "816-413-8285",
            "fax_number": "816-413-8662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROBST",
        "first_name": "EDWARD",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2008-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "014353",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "MO. 14353",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "402143200",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Bishop, PHARM.D.
• Haley Bogers, MS, CCC-SLP
• Robert Kent Boland, DDS
• Thomas J Bono, DDS
• Rebecca Lynn Boren, LPC
• Amy Ruth Bryan, PHARM.D.
• Aaron Bumann, D.D.S.
• Madison Nicole Burnett
• Burton Dialysis LLC (Happy Rock Dialysis)
• Angela Cabreza, MA, BCBA, LBA

• General Practice Dentistry in Gladstone, MO
• Providers in Gladstone, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; 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.