NPIMap

Organization Active NPI

Periodontal Care, P.a.

  • Periodontics
  • Prairie Village, KS
National Provider Identifier
1558883181
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
2010016137 Issued in MO
Legal business name
PERIODONTAL CARE, P.A.
Practice address
5000 W 95TH St Ste 270
Prairie Village, KS 66207-3300
Phone
(913) 341-4141
Fax
(913) 341-4432
NPI assigned
Jul 14, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Ms. Anne E Peterson, JD, CDFA, MS
Title
Business Manager
Phone
(913) 681-8100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 2010016137 MO Primary

Addresses

Primary practice location

5000 W 95TH St Ste 270
Prairie Village, KS 66207-3300

Mailing address

5000 W 95TH St Ste 270
Prairie Village, KS 66207-3300
Phone (913) 341-4141

Other practice location 1

5707 NW 64th Ter
Kansas City, MO 64151-2382
Phone (816) 741-3830

National Provider Directory

National Provider Directory

Locations

5000 W 95th St
Ste 270
Prairie Village, KS 66207
Phone (913) 341-4141

Practitioners & affiliated clinicians

Practitioners 3

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": "1499990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1558883181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 W 95TH ST STE 270",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662073300",
            "telephone_number": "913-341-4141",
            "fax_number": "913-341-4432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 W 95TH ST STE 270",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662073300",
            "telephone_number": "913-341-4141",
            "fax_number": "913-341-4432"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5707 NW 64th Ter",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641512382",
            "country_code": "US",
            "telephone_number": "816-741-3830",
            "fax_number": "816-741-2693",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PERIODONTAL CARE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-14",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "ANNE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "913-681-8100",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "JD, CDFA, MS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "MO",
            "license": "2010016137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prairie Village, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.