Moundridge Dental Center Chartered

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

60728 Issued in KS

Legal business name

MOUNDRIDGE DENTAL CENTER CHARTERED

Practice address

324 E 2ND St
Moundridge, KS 67107-7164

Phone

(620) 345-2100

Fax

(620) 345-2106

NPI assigned

Oct 22, 2010

Last updated

Oct 22, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jay Warren Hildreth Jr., DDS

Title

Owner

Phone

(785) 456-7083

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• J. Warren Hildreth Jr., DDS

  • General Practice Dentistry
  • Wichita, KS
  • NPI 1124237268
  NPD (past)

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

{
    "created_epoch": "1287705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350864000000",
    "number": "1538469671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5566 MAEFIELD DR STE B",
            "city": "WAMEGO",
            "state": "KS",
            "postal_code": "665479109",
            "telephone_number": "785-456-7083",
            "fax_number": "785-456-6520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 E 2ND ST",
            "city": "MOUNDRIDGE",
            "state": "KS",
            "postal_code": "671077164",
            "telephone_number": "620-345-2100",
            "fax_number": "620-345-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNDRIDGE DENTAL CENTER CHARTERED",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-22",
        "last_updated": "2012-10-22",
        "status": "A",
        "authorized_official_last_name": "HILDRETH",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "WARREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "785-456-7083",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "60728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Memorial Home, Inc.
• Mercy Hospital Inc
• Mercy Hospital Inc
• Michelle Porter Otr Inc.
• Anna Grace Miller, OTD
• Moundridge Dental, P.a.
• Moundridge Manor Inc.
• Moundridge Usd423
• New Beginnings Counseling and Educational Services
• Partners in Family Care LLC

• General Practice Dentistry in Moundridge, KS
• Providers in Moundridge, KS by specialty
• General Practice Dentistry in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; 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.