Individual provider Active NPI

Emily Clare Bartell Drake, D.D.S

  • Pediatric Dentistry
  • Kansas City, MO
National Provider Identifier
1487628053
Registry record updated Feb 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
2011017345 Issued in MO
Practice address
3801 Southwest Trfy
Kansas City, MO 64111-2902
Phone
(816) 622-2000
Fax
(816) 298-9214
NPI assigned
Feb 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 2011017345 MO Primary
Dentist 122300000X 6537 NE

Addresses

Primary practice location

3801 Southwest Trfy
Kansas City, MO 64111-2902

Mailing address

3801 Southwest Trfy
Kansas City, MO 64111-2902
Phone (816) 622-2000

Other practice location 1

104 Archibald St
Kansas City, MO 64111-2230
Phone (816) 531-0382

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

LicenseStateTypeSpecialty
6537NEMDDentist
2011017345MOMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas City Pediatric Dentistry LLC Pediatric Dentistry CurrentSince Feb 16, 2020 Accepting new patients
Westport Family Dental, LLC PastSince Aug 23, 2020 Accepting new patients
Keith Dental Westport LLC Past Accepting new patients

Locations

3801 Southwest Trfy
Kansas City, MO 64111
Phone (816) 622-2000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1487628053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 SOUTHWEST TRFY",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641112902",
            "telephone_number": "816-622-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 SOUTHWEST TRFY",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641112902",
            "telephone_number": "816-622-2000",
            "fax_number": "816-298-9214"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 Archibald St",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641112230",
            "country_code": "US",
            "telephone_number": "816-531-0382",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "EMILY",
        "middle_name": "CLARE BARTELL",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MO",
            "license": "2011017345",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "6537",
            "primary": false
        }
    ],
    "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 Feb 12, 2020; 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.