Independence Avenue Dental LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

INDEPENDENCE AVENUE DENTAL LLC

Doing business as

True Dental Group

Practice address

1638 West 24 Highway
Independence, MO 64050

Phone

(816) 461-6911

Fax

(816) 461-3675

NPI assigned

Jan 12, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Randal Adam Silver, DMD

Title

Owner

Phone

(816) 461-6911

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• True Dental Group Doing business as

Locations

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

{
    "created_epoch": "1231718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591833600000",
    "number": "1396982468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1638 WEST 24 HIGHWAY",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "64050",
            "telephone_number": "816-461-6911",
            "fax_number": "816-461-3675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1638 WEST 24 HIGHWAY",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "64050",
            "telephone_number": "816-461-6911",
            "fax_number": "816-461-3675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE AVENUE DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-12",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A",
        "authorized_official_last_name": "SILVER",
        "authorized_official_first_name": "RANDAL",
        "authorized_official_middle_name": "ADAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "816-461-6911",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "404078503",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "True Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dental Clinic/Center in Independence, MO
• Providers in Independence, MO by specialty
• Dental Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.