NPIMap

Organization Active NPI

Southeast Missouri Health Network

Doing business as BERNIE DENTAL Clinic

  • Federally Qualified Health Center (FQHC)
  • Bernie, MO
National Provider Identifier
1598069247
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SOUTHEAST MISSOURI HEALTH NETWORK
Doing business as
BERNIE DENTAL Clinic
Practice address
741 S Walnut St
Bernie, MO 63822-8900
Phone
(573) 293-6930
Fax
(573) 293-6841
NPI assigned
Jan 10, 2011
Last updated
Mar 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Authorized official

Name
Ms. Sara Deane
Title
Chief Financial Officer
Phone
(573) 313-2500

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

741 S Walnut St
Bernie, MO 63822-8900

Mailing address

741 South Walnut
Bernie, MO 63822
Phone (573) 293-6930

Other names 1

  • BERNIE DENTAL Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southeast Missouri Network14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1294617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616371200000",
    "number": "1598069247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 SOUTH WALNUT",
            "city": "BERNIE",
            "state": "MO",
            "postal_code": "63822",
            "telephone_number": "573-293-6930",
            "fax_number": "573-293-6841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 S WALNUT ST",
            "city": "BERNIE",
            "state": "MO",
            "postal_code": "638228900",
            "telephone_number": "573-293-6930",
            "fax_number": "573-293-6841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST MISSOURI HEALTH NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-10",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A",
        "authorized_official_last_name": "DEANE",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "573-313-2500",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BERNIE DENTAL Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BERNIE DENTAL Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bernie, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; 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.