Active NPI
Dirk Bradford Eckroat, D.D.S.
- Dentist
- Kansas City, MO
National Provider Identifier
1417212846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2012016211
- Practice address
- 2401 Gillham Rd
Kansas City, MO 64108-4619 - Phone
- (816) 234-3257
- NPI assigned
- Jul 11, 2012
- 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 | 2012016211 | MO | Primary |
Addresses
Primary practice location
2401 Gillham Rd
Kansas City, MO 64108-4619
Mailing address
309 Emanuel Cleaver II Blvd
Unit #204
Kansas City, MO 64112-1792
Phone (405) 245-4117
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 |
|---|---|---|---|
| 2012016211 | MO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341964800000",
"number": "1417212846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "309 EMANUEL CLEAVER II BLVD",
"address_2": "UNIT #204",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641121792",
"telephone_number": "405-245-4117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2401 GILLHAM RD",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641084619",
"telephone_number": "816-234-3257"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ECKROAT",
"first_name": "DIRK",
"middle_name": "BRADFORD",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-11",
"last_updated": "2012-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2012016211",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jul 11, 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.