Peds, LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

2014012737 Issued in MO

Legal business name

PEDS, LLC

Practice address

4741 Central St
Suite #107
Kansas City, MO 64112-1533

Phone

(402) 972-7751

NPI assigned

Aug 18, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Matthew David Anderson, D.D.S.

Title

Organizer

Phone

(402) 972-7751

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1408320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408320000000",
    "number": "1336548106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4741 CENTRAL ST",
            "address_2": "SUITE #107",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641121533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4741 CENTRAL ST",
            "address_2": "SUITE #107",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641121533",
            "telephone_number": "402-972-7751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-18",
        "last_updated": "2014-08-18",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "ORGANIZER",
        "authorized_official_telephone_number": "402-972-7751",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MO",
            "license": "2014012737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric Therapy Services, Inc.
• Pediatrix
• Pediatrix Medical Group
• Christopher Allen Pedroza, DPT
• Lisa Marie Pedroza, PHARMD
• Yolonda Monique Peeler
• Simon Ray Peery, D.C.
• Marcia Peetz
• Megan Marie Peffley-Stone, MD
• Shamika Pegue

• Pediatric Dentistry in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Pediatric Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2014; 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.