Organization Active NPI

James L. McCreary DDS

  • Dental Assistant
  • Kansas City, MO
National Provider Identifier
1407127004
Registry record updated Jan 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AssistantTaxonomy code 126800000X
License
11801 Issued in MO
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

Updated by the provider on Jan 13, 2012

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)CodeLicenseStatePrimary
Dental AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 126800000X 11801 MO Primary
Dental AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
000548MedicaidMO

Other names 1

  • Citadel Dental Group KC MO Other name

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.