NPIMap

Organization Active NPI

Douglas a Wyckoff DDS PC

  • General Practice Dentistry
  • Cameron, MO
National Provider Identifier
1376734145
Registry record updated Aug 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
015416 Issued in MO
Legal business name
DOUGLAS A WYCKOFF DDS PC
Practice address
1801 N Walnut
Cameron, MO 64429
Phone
(816) 632-2822
Fax
(816) 632-5245
NPI assigned
Aug 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2007

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

Authorized official

Name
Dr. Douglas Allen Wyckoff, DDS PCNPI 1598812968
Title
Owner
Phone
(816) 632-2822

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 015416 MO Primary

Addresses

Primary practice location

1801 N Walnut
Cameron, MO 64429

Mailing address

PO Box 464
Cameron, MD 64429
Phone (816) 632-2822

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186444800000",
    "number": "1376734145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 464",
            "city": "CAMERON",
            "state": "MD",
            "postal_code": "64429",
            "telephone_number": "816-632-2822",
            "fax_number": "816-632-5245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 N WALNUT",
            "city": "CAMERON",
            "state": "MO",
            "postal_code": "64429",
            "telephone_number": "816-632-2822",
            "fax_number": "816-632-5245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS A WYCKOFF DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-07",
        "last_updated": "2007-08-07",
        "status": "A",
        "authorized_official_last_name": "WYCKOFF",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "816-632-2822",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS PC"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "015416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cameron, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.

Verify at the official NPI Registry.