Individual provider Active NPI

Richard J. Alvarez, D.D.S.

  • Dentist
  • Branson, MO
National Provider Identifier
1619081957
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14458 Issued in MO
Practice address
1193 Branson Hills Pkwy
Branson, MO 65616-9942
Phone
(417) 213-3025
NPI assigned
Aug 17, 2006
Last updated
Jan 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5150 OK
Dentist 122300000X 14458 MO Primary

Addresses

Primary practice location

1193 Branson Hills Pkwy
Branson, MO 65616-9942

Mailing address

183 Royal Dornoch Dr
Branson, MO 65616-7414
Phone (417) 320-1043

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160901001152 MO Order and Referring Only - DentistPractitioner - Dentist 4981990819

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14458MOMDDentist
5150OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kapilikisha DMD LLC CurrentSince Mar 20, 2022 Accepting new patients
Simply Smiles Family Dental, Richard Alvarez, DDS, LLC CurrentSince Feb 2, 2020 Accepting new patients

Locations

1193 Branson Hills Pkwy
Branson, MO 65616
Phone (417) 213-3025

1093 US Highway 60 E
Republic, MO 65738
Phone (417) 732-6785

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1619081957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 ROYAL DORNOCH DR",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656167414",
            "telephone_number": "417-320-1043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1193 BRANSON HILLS PKWY",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656169942",
            "telephone_number": "417-213-3025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALVAREZ",
        "first_name": "RICHARD",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "5150",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "14458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Branson, MO

Sources for this page

Verify at the official NPI Registry.