Active NPI
Edward Ray Oman, DDS
- Dentist
- Raytown, MO
National Provider Identifier
1376645523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 010460
- Practice address
- 6115 Blue Ridge Blvd
Raytown, MO 64133 - Phone
- (816) 358-4428
- Fax
- (816) 358-4460
- NPI assigned
- Sep 1, 2006
- 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 | 010460 | MO | Primary |
Addresses
Primary practice location
6115 Blue Ridge Blvd
Raytown, MO 64133
Mailing address
6115 Blue Ridge Blvd
Raytown, MO 64133
Phone (816) 358-4428
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0010460MO | Other | MO | DELTA DENTAL |
| 05471012 | Other | MO | BLUE CROSS BLUE SHIELD |
| 70408 | Other | MO | FORTIS |
| 716511 | Other | MO | UNITED CONCORDIA |
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 |
|---|---|---|---|
| 010460 | MO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376645523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6115 BLUE RIDGE BLVD",
"city": "RAYTOWN",
"state": "MO",
"postal_code": "64133",
"telephone_number": "816-358-4428",
"fax_number": "816-358-4460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6115 BLUE RIDGE BLVD",
"city": "RAYTOWN",
"state": "MO",
"postal_code": "64133",
"telephone_number": "816-358-4428",
"fax_number": "816-358-4460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OMAN",
"first_name": "EDWARD",
"middle_name": "RAY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "010460",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DELTA DENTAL",
"identifier": "0010460MO",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "05471012",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FORTIS",
"identifier": "70408",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "716511",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Raytown, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.