Individual provider Active NPI

Chih-Yun Tao

  • Periodontics
  • Shawnee, KS
National Provider Identifier
1619420023
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
62188 Issued in KS
Practice address
6333 Long Ave Ste 201
Shawnee, KS 66216-2544
Phone
(913) 268-9300
NPI assigned
Aug 2, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 2020039834 MO
Student in an Organized Health Care Education/Training Program 390200000X
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 62188 KS Primary

Addresses

Primary practice location

6333 Long Ave Ste 201
Shawnee, KS 66216-2544

Mailing address

6333 Long Ave Ste 201
Shawnee, KS 66216-2544
Phone (913) 268-9300

Other practice location 1

207 E 63rd St
Kansas City, MO 64113-2224
Phone (816) 561-8466

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220110000832 MO Order and Referring Only - DentistPractitioner - DentistPractitioner - Pathology 2860884590

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tao LLC CurrentSince Jan 12, 2025 Accepting new patients
Ann Fay Periodontics PastSince Feb 8, 2023 Accepting new patients

Locations

6333 Long Ave
Ste 201
Shawnee, KS 66216
Phone (913) 268-9300

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": "1470096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1619420023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6333 LONG AVE STE 201",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662162544",
            "telephone_number": "913-268-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6333 LONG AVE STE 201",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662162544",
            "telephone_number": "913-268-9300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 E 63rd St",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641132224",
            "country_code": "US",
            "telephone_number": "816-561-8466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAO",
        "first_name": "CHIH-YUN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-02",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MO",
            "license": "2020039834",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "KS",
            "license": "62188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, KS

Sources for this page

Verify at the official NPI Registry.