Individual provider Active NPI

Mohammed Nuru, DDS

  • General Practice Dentistry
  • Kansas City, MO
National Provider Identifier
1447804091
Registry record updated Sep 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2019029154 Issued in MO
Practice address
3801 Dr Martin Luther King Jr Blvd
Kansas City, MO 64130-2807
Phone
(816) 923-5800
NPI assigned
Jul 31, 2019
Last updated
Sep 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2019029154 MO Primary

Addresses

Primary practice location

3801 Dr Martin Luther King Jr Blvd
Kansas City, MO 64130-2807

Mailing address

3801 Dr Martin Luther King Jr Blvd
Kansas City, MO 64130-2807
Phone (816) 923-5800

Other practice location 1

2906 NW Vivion Rd
Riverside, MO 64150-1502
Phone (816) 599-5051

Other practice location 2

6406 E 87th St
Kansas City, MO 64138-2800
Phone (816) 321-3200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240206004283 MO Practitioner - Dentist 8921434499 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Swope Health Services CurrentSince Dec 24, 2023 Accepting new patients
Swope Health Services CurrentSince Dec 24, 2023 Accepting new patients
Swope Health Services PastSince Nov 26, 2023 Accepting new patients
Alex R Sharifian DDS Dentists of Independence PC PastSince Aug 1, 2019 Accepting new patients

Locations

17844 E 23rd St S
Independence, MO 64057
Phone (816) 257-9716

3801 Dr Martin Luther King Jr Blvd
Kansas City, MO 64130
Phone (816) 599-5500

6406 E 87th St
Kansas City, MO 64138
Phone (816) 321-3200

2906 NW Vivion Rd
Riverside, MO 64150
Phone (816) 599-5050

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790726400000",
    "number": "1447804091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 DR MARTIN LUTHER KING JR BLVD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641302807",
            "telephone_number": "816-923-5800",
            "fax_number": "816-922-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 DR MARTIN LUTHER KING JR BLVD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641302807",
            "telephone_number": "816-923-5800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2906 NW Vivion Rd",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "MO",
            "postal_code": "641501502",
            "country_code": "US",
            "telephone_number": "816-599-5051",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6406 E 87th St",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641382800",
            "country_code": "US",
            "telephone_number": "816-321-3200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NURU",
        "first_name": "MOHAMMED",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-31",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2019029154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.