Active NPI
James L. McCreary DDS
- Dental Assistant
- Kansas City, MO
National Provider Identifier
1407127004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- License
- 11801
- Legal business name
- JAMES L. MCCREARY DDS
- Practice address
- 1734 E 63Rd Street
Suite #401
Kansas City, MO 64110 - Phone
- (816) 523-4444
- Fax
- (816) 523-2689
- NPI assigned
- Jan 13, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. James Larry McCreary, DDS
- Title
- Dentist-Owner of Practice
- Phone
- (816) 523-4444
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Assistant | 126800000X | 11801 | MO | Primary |
| Dental Assistant | 126800000X | 2006023201 | MO |
Addresses
Primary practice location
1734 E 63Rd Street
Suite #401
Kansas City, MO 64110
Mailing address
1734 E 63Rd Street
Suite #401
Kansas City, MO 64110
Phone (816) 523-4444
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000548 | Medicaid | MO |
Other names 1
- Citadel Dental Group KC MO
National Provider Directory
National Provider DirectoryLocations
1734 E 63rd St
Ste 401
Kansas City, MO 64110
Phone (816) 523-4444
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326412800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1326412800000",
"number": "1407127004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1734 E 63RD STREET",
"address_2": "SUITE #401",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "64110",
"telephone_number": "816-523-4444",
"fax_number": "816-523-2689"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1734 E 63RD STREET",
"address_2": "SUITE #401",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "64110",
"telephone_number": "816-523-4444",
"fax_number": "816-523-2689"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JAMES L. MCCREARY DDS",
"organizational_subpart": "NO",
"enumeration_date": "2012-01-13",
"last_updated": "2012-01-13",
"status": "A",
"authorized_official_last_name": "MCCREARY",
"authorized_official_first_name": "JAMES",
"authorized_official_middle_name": "LARRY",
"authorized_official_title_or_position": "DENTIST-OWNER OF PRACTICE",
"authorized_official_telephone_number": "816-523-4444",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Dental Assistant",
"state": "MO",
"license": "11801",
"primary": true
},
{
"code": "126800000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Dental Assistant",
"state": "MO",
"license": "2006023201",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000548",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Citadel Dental Group KC MO",
"code": "5",
"type": "Other Name"
}
]
}
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 Jan 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.