Joplin Oral Surgery PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2007032185 Issued in MO

Legal business name

JOPLIN ORAL SURGERY PC

Practice address

2700 McClelland Blvd
BLDG C Suite 302
Joplin, MO 64804-1623

Phone

(417) 624-2333

Fax

(405) 848-0033

NPI assigned

May 6, 2008

Last updated

May 6, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Matthew W Sheffer, DDSNPI 1730222647

Title

Owner

Phone

(417) 624-2333

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew W Sheffer, DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Joplin, MO
  • NPI 1730222647
  NPD (past) Authorized official

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

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210032000000",
    "number": "1639345937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 MCCLELLAND BLVD",
            "address_2": "BLDG C SUITE 302",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041623",
            "telephone_number": "417-624-2333",
            "fax_number": "405-848-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 MCCLELLAND BLVD",
            "address_2": "BLDG C SUITE 302",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041623",
            "telephone_number": "417-624-2333",
            "fax_number": "405-848-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOPLIN ORAL SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-06",
        "last_updated": "2008-05-06",
        "status": "A",
        "authorized_official_last_name": "SHEFFER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-624-2333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "2007032185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORAL SURGERY LICENSE",
            "identifier": "2007032185",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Joplin, MO
• Providers in Joplin, MO by specialty
• Oral and Maxillofacial Surgery (Dentist) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; 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.