Individual provider Active NPI

Amanda N Sutton, DDS

  • Dentist
  • Wentzville, MO
National Provider Identifier
1578945176
Registry record updated Nov 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2015018856 Issued in MO
Practice address
1838 Wentzville Pkwy
Wentzville, MO 63385-3817
Phone
(636) 887-3005
NPI assigned
Jun 19, 2015
Last updated
Nov 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2015018856 MO Primary

Addresses

Primary practice location

1838 Wentzville Pkwy
Wentzville, MO 63385-3817

Mailing address

1838 Wentzville Pkwy
Wentzville, MO 63385-3817
Phone (636) 887-3005

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

LicenseStateTypeSpecialty
2015018856MOMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Kraner Family Dentistry Past Accepting new patients
DRS.Kraner and Kraner , LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480291200000",
    "number": "1578945176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1838 WENTZVILLE PKWY",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633853817",
            "telephone_number": "636-887-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1838 WENTZVILLE PKWY",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633853817",
            "telephone_number": "636-887-3005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTON",
        "first_name": "AMANDA",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-19",
        "last_updated": "2016-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2015018856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wentzville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2016; 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.