Active NPI
Tanner James Neeland
- Dentist
- Independence, MO
National Provider Identifier
1306413299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2021019493
- Practice address
- 3901 S Bolger Rd
Independence, MO 64055-6779 - Phone
- (816) 708-3760
- NPI assigned
- Jun 8, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2021019493 | MO | Primary |
Addresses
Primary practice location
3901 S Bolger Rd
Independence, MO 64055-6779
Mailing address
4504 Washington St
Kansas City, MO 64111-3321
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021019493 | MO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623196800000",
"number": "1306413299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4504 WASHINGTON ST",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641113321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3901 S BOLGER RD",
"city": "INDEPENDENCE",
"state": "MO",
"postal_code": "640556779",
"telephone_number": "816-708-3760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEELAND",
"first_name": "TANNER",
"middle_name": "JAMES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-08",
"last_updated": "2021-06-09",
"certification_date": "2021-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2021019493",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Independence, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.