NPIMap

Organization Active NPI

Kirksville Dental Group

  • Dentist
  • Kirksville, MO
National Provider Identifier
1306993373
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
KIRKSVILLE DENTAL GROUP
Practice address
1916 N Baltimore St
Kirksville, MO 63501-1902
Phone
(660) 665-1901
NPI assigned
Jan 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Pam Morgan
Title
Treatment Coordinator
Phone
(660) 665-1901

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

1916 N Baltimore St
Kirksville, MO 63501-1902

Mailing address

1916 N Baltimore St
Kirksville, MO 63501-1902
Phone (660) 665-1901

National Provider Directory

National Provider Directory

Locations

1916 N Baltimore St
Kirksville, MO 63501
Phone (660) 665-1901

Practitioners & affiliated clinicians

Practitioners 5

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": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306993373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1916 N BALTIMORE ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635011902",
            "telephone_number": "660-665-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1916 N BALTIMORE ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635011902",
            "telephone_number": "660-665-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIRKSVILLE DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MORGAN",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "TREATMENT COORDINATOR",
        "authorized_official_telephone_number": "660-665-1901"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirksville, MO

Sources for this page

  • 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.