Individual provider Active NPI

Walter James Cook, DDS

  • Dentist
  • Kansas City, MO
National Provider Identifier
1275257545
Registry record updated Sep 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2022038746 Issued in MO
Practice address
9018 N Skyview Ave
Kansas City, MO 64154-8501
Phone
(816) 741-5113
NPI assigned
Sep 30, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 61989 KS
Dentist 122300000X 2022038746 MO Primary

Addresses

Primary practice location

9018 N Skyview Ave
Kansas City, MO 64154-8501

Mailing address

9018 N Skyview Ave
Kansas City, MO 64154-8501
Phone (816) 741-5113

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20221228001259 MO Order and Referring Only - DentistPractitioner - Dentist 5991175432

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61989KSMDDentist
2022038746MOMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Alex Sharifian, D.D.S., Tiffany Springs Dental Group, P.C. PastSince Oct 2, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1664496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1275257545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9018 N SKYVIEW AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641548501",
            "telephone_number": "816-741-5113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9018 N SKYVIEW AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641548501",
            "telephone_number": "816-741-5113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "WALTER",
        "middle_name": "JAMES",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-30",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KS",
            "license": "61989",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2022038746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.