Robert Daniel Dunavant, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2019020350 Issued in MO

Practice address

1059 Barton Dr
Fordland, MO 65652-7350

Phone

(417) 767-2100

NPI assigned

Jul 8, 2011

Last updated

Mar 2, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Dr. D's Family Dentistry, LLC

  • Dentist
  • Bartlett, TN
  • NPI 1134542756
  NPD (past)

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1295022341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1059 BARTON DR",
            "city": "FORDLAND",
            "state": "MO",
            "postal_code": "656527350",
            "telephone_number": "417-767-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1059 BARTON DR",
            "city": "FORDLAND",
            "state": "MO",
            "postal_code": "656527350",
            "telephone_number": "417-767-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNAVANT",
        "first_name": "ROBERT",
        "middle_name": "DANIEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-08",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2019020350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peggy S Cargin, NP
• Debby Sue Carl, FNP-C
• Angela Coleen Moore Clay, D.O.
• Kayla Cummings, RN
• Tina Nichole Drozdowski, RDH
• Ronica Jean Duncan, MSW, LCSW
• Fordland Clinic, Inc.
• Fordland Clinic, Inc.
• Fordland R-3 School Dist
• Dave Gooden, MSW LCSW

• Dentist in Fordland, MO
• Providers in Fordland, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2020; 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.