Active NPI
Allen D. Rodgers, DDS
- Dentist
- Richland, MO
National Provider Identifier
1407987555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2001028736
- Practice address
- 304 W Washington Ave
Richland, MO 65556-7101 - Phone
- (573) 765-5131
- Fax
- (573) 765-3122
- NPI assigned
- Mar 8, 2007
- Last updated
- Jul 9, 2007
- 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 | 2001028736 | MO | Primary |
Addresses
Primary practice location
304 W Washington Ave
Richland, MO 65556-7101
Mailing address
304 W Washington Ave
P.O. Box 777
Richland, MO 65556-7101
Phone (573) 765-5131
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | MO |
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 |
|---|---|---|---|
| 2001028736 | MO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1407987555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "304 W WASHINGTON AVE",
"address_2": "P.O. BOX 777",
"city": "RICHLAND",
"state": "MO",
"postal_code": "655567101",
"telephone_number": "573-765-5131",
"fax_number": "573-765-3122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "304 W WASHINGTON AVE",
"city": "RICHLAND",
"state": "MO",
"postal_code": "655567101",
"telephone_number": "573-765-5131",
"fax_number": "573-765-3122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODGERS",
"first_name": "ALLEN",
"middle_name": "D.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-08",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2001028736",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Richland, MO
- Evan Stewart Reynolds
- Richland Care Center, Inc.
- Richland Medical Center, Inc (Central Ozarks Medical Center)
- Richland Medical Center, Inc. (Central Ozarks Medical Center)
- Richland Medical Center, Inc. (Central Ozarks Medical Center)
- Jaymie L Rodriguez, DNP, PMHNP
- Becki Ruggles, LPC, M. ED
- Alaina Nicole Santhuff
- Daniel M. Schmidt, M.D.
- Flora C Schofield, MO TEACHING CERTIFIC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.