Advanced Dentistry of Nevada Missouri

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

ADVANCED DENTISTRY OF NEVADA MISSOURI

Practice address

1701 W Austin Blvd
Nevada, MO 64772-3720

Phone

(417) 667-7134

NPI assigned

Mar 19, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Caleb Johnsen, DDSNPI 1457754004

Title

Owner

Phone

(816) 541-1897

Specialties & licenses 1

Addresses

Other names 1

• Advanced Dentistry of Nevada Doing business as

Practitioners 1

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

• Caleb Johnsen, DDS

  • Dentist
  • Tipton, MO
  • NPI 1457754004
  NPD Authorized official

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

{
    "created_epoch": "1742342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742342400000",
    "number": "1649070442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 W AUSTIN BLVD",
            "city": "NEVADA",
            "state": "MO",
            "postal_code": "647723720",
            "telephone_number": "417-667-7134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 W AUSTIN BLVD",
            "city": "NEVADA",
            "state": "MO",
            "postal_code": "647723720",
            "telephone_number": "417-667-7134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DENTISTRY OF NEVADA MISSOURI",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-19",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A",
        "authorized_official_last_name": "JOHNSEN",
        "authorized_official_first_name": "CALEB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "816-541-1897",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Dentistry of Nevada",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Eva M Allison, LMSW, MSW

• All providers in Nevada, MO
• Dental Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; 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.