Richard J. Alvarez, D.D.S.
Individual provider Active NPI Dentist · Branson, MO
NPI 1619081957 · NPPES record last updated Jan 28, 2020
Key facts
- NPI
- 1619081957
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 14458 (MO)
- Practice address
- 1193 Branson Hills Pkwy
Branson, MO 65616-9942 - Phone
- (417) 213-3025
- NPI assigned
- Aug 17, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160901001152 | MO | Order and Referring Only - Dentist |
4981990819 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14458 | MO | MD | Dentist |
| 5150 | OK | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kapilikisha DMD LLC | Current |
Accepting new patients | |
| Simply Smiles Family Dental, Richard Alvarez, DDS, LLC | Current |
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 5150 | OK | |
| Dentist | 122300000X | 14458 | MO | Yes |
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
Other providers in Branson, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.