Senior Dental Care of Mo, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SENIOR DENTAL CARE OF MO, LLC

Practice address

120 S Central Ave
Clayton, MO 63105-1705

Phone

(888) 674-1211

NPI assigned

Apr 14, 2021

Organization subpart

No

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

Authorized official

Name

John Rosenbaum

Title

Chief Financial Officer

Phone

(913) 647-7926

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1618358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618358400000",
    "number": "1447830294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8500 W 110TH ST STE 450",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662104029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S CENTRAL AVE",
            "city": "CLAYTON",
            "state": "MO",
            "postal_code": "631051705",
            "telephone_number": "888-674-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR DENTAL CARE OF MO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-14",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A",
        "authorized_official_last_name": "ROSENBAUM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "913-647-7926"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Schultz, OTR
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• Lydia M. Seibert, P.T.
• Eva Selph
• Senior Source CDS LLC
• Bryan Norbert Sewing, D.O.
• Lydia Shaffer
• Rachael Fuller Shaffer
• Sherie Kaplan, LCSW, LLC

• General Practice Dentistry in Clayton, MO
• Providers in Clayton, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; 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.