Organization Active NPI

Premier Dental L.L.C.

  • Dentist
  • Lee's Summit, MO
National Provider Identifier
1265985428
Registry record updated Jul 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2014018886 Issued in MO
Legal business name
PREMIER DENTAL L.L.C.
Practice address
1648 SE Blue Parkway
Lee's Summit, MO 64063
Phone
(816) 517-6500
NPI assigned
Jul 25, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2016

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

Authorized official

Name
Dr. Stephan Denis Caye, DDSNPI 1760896831
Title
Dentist
Phone
(816) 517-6500

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 2014018886 MO Primary

Addresses

Primary practice location

1648 SE Blue Parkway
Lee's Summit, MO 64063

Mailing address

1648 SE Blue Parkway
Lee's Summit, MO 64063
Phone (816) 517-6500

Other identifiers 1

IdentifierTypeStateIssuer
1760896831OtherMONPI

National Provider Directory

National Provider Directory

Locations

1648 SE Blue Pkwy
Lees Summit, MO 64063
Phone (816) 517-6500

Practitioners & affiliated clinicians

Practitioners 1

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": "1469404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469404800000",
    "number": "1265985428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1648 SE BLUE PARKWAY",
            "city": "LEE'S SUMMIT",
            "state": "MO",
            "postal_code": "64063",
            "telephone_number": "816-517-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1648 SE BLUE PARKWAY",
            "city": "LEE'S SUMMIT",
            "state": "MO",
            "postal_code": "64063",
            "telephone_number": "816-517-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER DENTAL L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-25",
        "last_updated": "2016-07-25",
        "status": "A",
        "authorized_official_last_name": "CAYE",
        "authorized_official_first_name": "STEPHAN",
        "authorized_official_middle_name": "DENIS",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "816-517-6500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MO",
            "license": "2014018886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1760896831",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lee's Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2016; 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.