Active NPI
Matthew D Tinnel, D.D.S.
- Dentist
- Kansas City, MO
National Provider Identifier
1316258395
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 60671
- Practice address
- 7900 Lees Summit Rd
Kansas City, MO 64139-1236 - Phone
- (816) 404-7000
- Fax
- (816) 404-6903
- NPI assigned
- Jun 24, 2010
- Last updated
- Jul 15, 2020
- 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 | 60671 | KS | Primary |
Addresses
Primary practice location
7900 Lees Summit Rd
Kansas City, MO 64139-1236
Mailing address
7900 Lees Summit Rd
Kansas City, MO 64139-1236
Phone (816) 404-7000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 407128404 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150610001383 | MO | Order and Referring Only - Dentist | 1850612292 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60671 | KS | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Steven D. Pendleton DDS PA | Past | Accepting new patients |
Interoperability endpoints
- matthew.tinnel@direct.tmcmed.org
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Kansas City, KS
- NPI 1023064607
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594771200000",
"number": "1316258395",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7900 LEES SUMMIT RD",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641391236",
"telephone_number": "816-404-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7900 LEES SUMMIT RD",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641391236",
"telephone_number": "816-404-7000",
"fax_number": "816-404-6903"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TINNEL",
"first_name": "MATTHEW",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-24",
"last_updated": "2020-07-15",
"certification_date": "2020-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KS",
"license": "60671",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "407128404",
"state": "MO"
}
],
"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 15, 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.