Robert Charles Paolillo, DDSPC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

012732 Issued in MO

Practice address

3904 Beck Rd
Suite 150
Saint Joseph, MO 64506-4952

Phone

(816) 279-3338

Fax

(816) 279-3339

NPI assigned

Sep 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 1, 2015 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Robert C. Paolillo,Ddspc

  • Oral and Maxillofacial Surgery (Dentist)
  • Saint Joseph, MO
  • NPI 1417058926
  NPD (past) Authorized official

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427159953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3904 BECK RD",
            "address_2": "SUITE 150",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645064952",
            "telephone_number": "816-279-3338",
            "fax_number": "816-279-3339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3904 BECK RD",
            "address_2": "SUITE 150",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645064952",
            "telephone_number": "816-279-3338",
            "fax_number": "816-279-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAOLILLO",
        "first_name": "ROBERT",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "DDSPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "012732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tomonori Alan Oyadomari, M.D.
• Amanda J Ozenberger, RN, MSN, PCCN, CPHQ
• P B Patel MD Professional
• Alicia Kay Palitto, MSN, ARNP, FNP-BC
• Stacie L. Palmer, DO
• Tamra C Paolillo, LCSW
• Halen Harley Parker
• Leslie A Parker, PLPC
• Lisa M Parker, DDS
• Matthew Aaron Parker, M.D.

• Oral and Maxillofacial Surgery (Dentist) in Saint Joseph, MO
• Providers in Saint Joseph, MO by specialty
• Oral and Maxillofacial Surgery (Dentist) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.