Formanek DDS LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

FORMANEK DDS LLC

Practice address

2226 Missouri Blvd
Jefferson City, MO 65109-4727

Phone

(573) 658-4022

NPI assigned

May 2, 2018

Organization subpart

No

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

Authorized official

Name

Joseph Formanek

Title

Owner

Phone

(573) 658-4022

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Oluwaseun Oginni, DDS

  • General Practice Dentistry
  • Jefferson City, MO
  • NPI 1720916943
  NPD (past)
• Bhavik Nilesh Patel, DDS

  • Dentist
  • Jefferson City, MO
  • NPI 1396333969
  NPD (past)
• Saxon Burton Teubner, DDS

  • General Practice Dentistry
  • Jefferson City, MO
  • NPI 1770329278
  NPD (past)

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

{
    "created_epoch": "1525219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686614400000",
    "number": "1508355900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70887",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441907088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2226 MISSOURI BLVD",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651094727",
            "telephone_number": "573-658-4022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORMANEK DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-02",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A",
        "authorized_official_last_name": "FORMANEK",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-658-4022"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas J. Folz, M.D.
• Deidra Leann Fooks, PTA
• Foot Health Center of Mid-Missouri LLC
• David Foote, PH.D.
• Timothy Foreman, MD
• Randy Forsee, LPN
• Beatriz Alejandra Fortaleza, ANP
• Kay Lea Foster
• Kimberly R Foster, LPC
• Sarah Foster

• General Practice Dentistry in Jefferson City, MO
• Providers in Jefferson City, 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 Jun 13, 2023; 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.