Individual provider Active NPI

Justin Garner, DDS

  • Dentist
  • Independence, MO
National Provider Identifier
1619176716
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2007016975 Issued in MO
Practice address
3904 S Lynn CT
Independence, MO 64055-3338
Phone
(816) 252-0055
NPI assigned
Jul 17, 2007
Last updated
Jan 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2007016975 MO Primary

Addresses

Primary practice location

3904 S Lynn CT
Independence, MO 64055-3338

Mailing address

3904 S Lynn CT
Independence, MO 64055-3338
Phone (816) 252-0055

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2007016975MOMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Justin Garner Dentistry Dentist CurrentSince Jan 15, 2023 Accepting new patients
Swope Health Services Past Accepting new patients
Swope Health Services Past Accepting new patients

Locations

3904 S Lynn Ct
Independence, MO 64055
Phone (816) 252-0055

Organizations & group practices 3

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": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1619176716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3904 S LYNN CT",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640553338",
            "telephone_number": "816-252-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3904 S LYNN CT",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640553338",
            "telephone_number": "816-252-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARNER",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-17",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2007016975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; 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.