Individual provider Active NPI

Paul Kent Overman, D.D.S.

  • General Practice Dentistry
  • Excelsior Springs, MO
National Provider Identifier
1629091046
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE014042 Issued in MO
Practice address
2107 N. Jesse James Road
Suite C
Excelsior Springs, MO 64024-2712
Phone
(816) 637-6000
Fax
(816) 630-9499
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE014042 MO Primary

Addresses

Primary practice location

2107 N. Jesse James Road
Suite C
Excelsior Springs, MO 64024-2712

Mailing address

2107 N. Jesse James Road
Suite C
Excelsior Springs, MO 64024-2712
Phone (816) 637-6000

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DE014042MOMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629091046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2107 N. JESSE JAMES ROAD",
            "address_2": "SUITE C",
            "city": "EXCELSIOR SPRINGS",
            "state": "MO",
            "postal_code": "640242712",
            "telephone_number": "816-637-6000",
            "fax_number": "816-630-9499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2107 N. JESSE JAMES ROAD",
            "address_2": "SUITE C",
            "city": "EXCELSIOR SPRINGS",
            "state": "MO",
            "postal_code": "640242712",
            "telephone_number": "816-637-6000",
            "fax_number": "816-630-9499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERMAN",
        "first_name": "PAUL",
        "middle_name": "KENT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "DE014042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Excelsior Springs, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.