Active NPI
Gyula Takacs, DDS
- General Practice Dentistry
- Lebanon, MO
National Provider Identifier
1518937192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2007025037
- Practice address
- 833 Howard Dr
Lebanon, MO 65536-4110 - Phone
- (417) 991-3400
- Fax
- (417) 991-3101
- NPI assigned
- Jan 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2007025037 | MO | Primary |
Addresses
Primary practice location
833 Howard Dr
Lebanon, MO 65536-4110
Mailing address
833 Howard Dr
Lebanon, MO 65536-4110
Phone (417) 991-3400
Other practice location 1
BLDG 38717 38TH Street
USA Dentac
Ft Gordon, GA 30905-5660
Phone (706) 787-6927
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2007025037 | Other | MO | STATE LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | info@ozarkdentalstudio.com | Direct |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2007025037 | MO | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574726400000",
"number": "1518937192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "833 HOWARD DR",
"city": "LEBANON",
"state": "MO",
"postal_code": "655364110",
"telephone_number": "417-991-3400",
"fax_number": "417-991-3101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "833 HOWARD DR",
"city": "LEBANON",
"state": "MO",
"postal_code": "655364110",
"telephone_number": "417-991-3400",
"fax_number": "417-991-3101"
}
],
"practiceLocations": [
{
"address_1": "BLDG 38717 38TH STREET",
"address_2": "USA DENTAC",
"address_purpose": "LOCATION",
"city": "FT GORDON",
"state": "GA",
"postal_code": "309055660",
"country_code": "US",
"telephone_number": "706-787-6927",
"fax_number": "706-787-2082",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TAKACS",
"first_name": "GYULA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-25",
"last_updated": "2019-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MO",
"license": "2007025037",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "2007025037",
"state": "MO"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "info@ozarkdentalstudio.com",
"affiliation": "N",
"endpointDescription": "email address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "communication",
"address_1": "833 Howard Dr",
"city": "Lebanon",
"state": "MO",
"country_code": "US",
"postal_code": "655364110",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Lebanon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.