Jahn E. Roedemeier, DDS, PA

Primary specialty

DentistTaxonomy code 122300000X

License

5872 Issued in KS

Legal business name

JAHN E. ROEDEMEIER, DDS, PA

Practice address

4601 W 109TH St
Suite 320
Overland Park, KS 66211-1318

Phone

(913) 387-4217

Fax

(913) 381-0515

NPI assigned

May 8, 2014

Organization subpart

No

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

Authorized official

Name

Ms. Anna L Brubaker

Title

Administrator

Phone

(816) 522-1230

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1399507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399507200000",
    "number": "1629488952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 W 109TH ST",
            "address_2": "320",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111318",
            "telephone_number": "913-387-4217",
            "fax_number": "913-381-0515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 W 109TH ST",
            "address_2": "SUITE 320",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111318",
            "telephone_number": "913-387-4217",
            "fax_number": "913-381-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAHN E. ROEDEMEIER, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-08",
        "last_updated": "2014-05-08",
        "status": "A",
        "authorized_official_last_name": "BRUBAKER",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "816-522-1230",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "KS",
            "license": "5872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE I",
            "identifier": "1063594083",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Dentist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2014; 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.