Southtown Family Dental LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SOUTHTOWN FAMILY DENTAL LLC

Doing business as

Southtown Family Dental

Practice address

19 E Gregory Blvd
Kansas City, MO 64114-1117

Phone

(816) 603-1737

Fax

(816) 652-0808

NPI assigned

Aug 12, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Richard S Campos, DMD, MSNPI 1710530464

Title

Dentist/Owner

Phone

(816) 603-1737

Specialties & licenses 1

Addresses

Other names 1

• Southtown Family Dental Doing business as

Practitioners 2

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

• Richard S Campos, DMD

  • General Practice Dentistry
  • Kansas City, MO
  • NPI 1710530464
  NPD Authorized official
• Jeffrey Joseph Speak, RDH

  • Dental Hygienist
  • Kansas City, MO
  • NPI 1659203537
  NPD (past)

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740614400000",
    "number": "1285465120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 E GREGORY BLVD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641141117",
            "telephone_number": "573-201-9262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 E GREGORY BLVD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641141117",
            "telephone_number": "816-603-1737",
            "fax_number": "816-652-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHTOWN FAMILY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-12",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A",
        "authorized_official_last_name": "CAMPOS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "816-603-1737",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southtown Family Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southtown Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Daniel Ryan Sounakhen, DC
• Dennis Sourvanos, DDS
• Michelle Sousley
• Lyndsay Deane South, PA, ABA
• Sara Southern, LICSW
• Southtown Womens Clinic LLC
• James L Southwell Jr., DO
• Southwest Care LLC
• Olayemi Sowemimo, DC
• Ashlynn Sowers, RN, MSN, NNP-BC

• Dental Clinic/Center in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Dental Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; 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.