Roger L Fender DDS

Primary specialty

DentistTaxonomy code 122300000X

License

MO 14150 Issued in MO

Legal business name

ROGER L FENDER DDS

Doing business as

Fender Family Dentistry

Practice address

519 SW 3Rd St
Suite G
Lees Summit, MO 64063-2258

Phone

(816) 524-3434

Fax

(816) 524-3622

NPI assigned

Dec 1, 2005

Organization subpart

No

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

Authorized official

Name

Roger Loren Fender, DDS

Title

Owner

Phone

(816) 524-3434

Specialties & licenses 1

Addresses

Other names 1

• Fender Family Dentistry Doing business as

Locations

Practitioners 1

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

• Samuel John Douglas, DDS

  • Dentist
  • Lees Summit, MO
  • NPI 1124867924
  NPD (past)

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295719417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2496",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640636496",
            "telephone_number": "816-524-3434",
            "fax_number": "816-524-3622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 SW 3RD ST",
            "address_2": "SUITE G",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640632258",
            "telephone_number": "816-524-3434",
            "fax_number": "816-524-3622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGER L FENDER DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FENDER",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "LOREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "816-524-3434",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MO",
            "license": "MO 14150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fender Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Valerie Rogers, RD
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• Emily Jean Rooney, LMSW
• Susan Root

• Dentist in Lees Summit, MO
• Providers in Lees Summit, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.