NPIMap

Organization Active NPI

Shoal Creek Pediatric Dentistry, L.L.C.

  • Pediatric Dentistry
  • Kansas City, MO
National Provider Identifier
1295998144
Registry record updated Jul 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
2005034207 Issued in MO
Legal business name
SHOAL CREEK PEDIATRIC DENTISTRY, L.L.C.
Practice address
9051 NE 81St Terrace
Suite 220
Kansas City, MO 64158
Phone
(816) 781-5437
NPI assigned
Jul 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2008

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

Authorized official

Name
Dr. David Scott Thomas, DDS
Title
President
Phone
(816) 781-5437

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 2005034207 MO Primary

Addresses

Primary practice location

9051 NE 81St Terrace
Suite 220
Kansas City, MO 64158

Mailing address

9051 NE 81St Terrace
Suite 220
Kansas City, MO 64158
Phone (816) 781-5437

National Provider Directory

National Provider Directory

Locations

9051 NE 81st Ter
Ste 220
Kansas City, MO 64158
Phone (816) 781-5437

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": "1215561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215561600000",
    "number": "1295998144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9051 NE 81ST TERRACE",
            "address_2": "SUITE 220",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64158",
            "telephone_number": "816-781-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9051 NE 81ST TERRACE",
            "address_2": "SUITE 220",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64158",
            "telephone_number": "816-781-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOAL CREEK PEDIATRIC DENTISTRY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-09",
        "last_updated": "2008-07-09",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "816-781-5437",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MO",
            "license": "2005034207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2008; 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.