NPIMap

Organization Active NPI

Georgetown Dental Associates LLC

  • General Practice Dentistry
  • Columbia, MO
National Provider Identifier
1558745950
Registry record updated Jul 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2006014447 Issued in MO
Legal business name
GEORGETOWN DENTAL ASSOCIATES LLC
Practice address
1601 Chapel Hill Rd
Suite a
Columbia, MO 65203-5462
Phone
(573) 445-9526
Fax
(573) 445-7950
NPI assigned
Jul 15, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2015

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

Authorized official

Name
Patrick Ryan, DDS
Title
Dentist
Phone
(573) 445-9526

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 2006014447 MO Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 2002016155 MO

Addresses

Primary practice location

1601 Chapel Hill Rd
Suite a
Columbia, MO 65203-5462

Mailing address

1601 Chapel Hill Rd
Suite a
Columbia, MO 65203-5462
Phone (573) 445-9526

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1436918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436918400000",
    "number": "1558745950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CHAPEL HILL RD",
            "address_2": "SUITE A",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652035462",
            "telephone_number": "573-445-9526",
            "fax_number": "573-445-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 CHAPEL HILL RD",
            "address_2": "SUITE A",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652035462",
            "telephone_number": "573-445-9526",
            "fax_number": "573-445-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGETOWN DENTAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-15",
        "last_updated": "2015-07-15",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "573-445-9526",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2006014447",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2002016155",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2015; 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.