NPIMap

Organization Active NPI

Ricky D. Powell, D.D.S., LLC

  • General Practice Dentistry
  • Boonville, MO
National Provider Identifier
1639313752
Registry record updated Apr 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13147 Issued in MO
Legal business name
RICKY D. POWELL, D.D.S., LLC
Practice address
1945 Boone Villa Dr
B
Boonville, MO 65233-2050
Phone
(660) 882-6452
NPI assigned
Apr 21, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2009

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

Authorized official

Name
Dr. Ricky Daryl Powell, D.D.S.NPI 1457495681
Title
Owner
Phone
(660) 882-6452

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 13147 MO Primary

Addresses

Primary practice location

1945 Boone Villa Dr
B
Boonville, MO 65233-2050

Mailing address

1945 Boone Villa Dr
B
Boonville, MO 65233-2050
Phone (660) 882-6452

National Provider Directory

National Provider Directory

Locations

1945 Boone Villa Dr
Ste B
Boonville, MO 65233
Phone (660) 882-6452

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1240272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240272000000",
    "number": "1639313752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 BOONE VILLA DR",
            "address_2": "B",
            "city": "BOONVILLE",
            "state": "MO",
            "postal_code": "652332050",
            "telephone_number": "660-882-6452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 BOONE VILLA DR",
            "address_2": "B",
            "city": "BOONVILLE",
            "state": "MO",
            "postal_code": "652332050",
            "telephone_number": "660-882-6452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICKY D. POWELL, D.D.S., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-21",
        "last_updated": "2009-04-21",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "RICKY",
        "authorized_official_middle_name": "DARYL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "660-882-6452",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "13147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boonville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2009; 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.