Joseph S. Whitehead, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2012021223 Issued in MO

Practice address

196 S McCleary Rd
Excelsior Springs, MO 64024-8456

Phone

(816) 630-5713

Fax

(641) 226-5759

NPI assigned

Jun 29, 2012

Last updated

Dec 21, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Dr. Joseph Whitehead Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Excelsior Springs Family Dentistry LLC

  • General Practice Dentistry
  • Excelsior Springs, MO
  • NPI 1508330986
  NPD (past)

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

{
    "created_epoch": "1340928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608508800000",
    "number": "1538423942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 S MCCLEARY RD",
            "city": "EXCELSIOR SPRINGS",
            "state": "MO",
            "postal_code": "640248456",
            "telephone_number": "816-630-5713",
            "fax_number": "641-226-5759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 S MCCLEARY RD",
            "city": "EXCELSIOR SPRINGS",
            "state": "MO",
            "postal_code": "640248456",
            "telephone_number": "816-630-5713",
            "fax_number": "641-226-5759"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 S Market St",
            "address_purpose": "LOCATION",
            "city": "Ottumwa",
            "state": "IA",
            "postal_code": "525012924",
            "country_code": "US",
            "telephone_number": "641-683-5773",
            "fax_number": "641-226-5759",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITEHEAD",
        "first_name": "JOSEPH",
        "middle_name": "S.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-29",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2012021223",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "09164",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2012021223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOSEPH",
            "last_name": "WHITEHEAD",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Mary Alice Troutman
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0195)
• Wal-Mart Stores East, LP (Vision Center 30-0195)
• Walgreen Co (Walgreens #11375)
• Anna M Wells, APRN
• Maegan Lynn Whitworth, PT, DPT
• Samantha Wilkins, LPN
• Kathryn Michelle Willimetz
• Angela T. Wilson, PT
• Cynthia NMN Wilson, PMHNP-C

• General Practice Dentistry in Excelsior Springs, MO
• Providers in Excelsior Springs, 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 Dec 21, 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.