Robert Dale Collinge, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

13458 Issued in MO

Practice address

107 N Main St
Edina, MO 63537-1426

Phone

(660) 397-2213

Fax

(660) 397-3929

NPI assigned

Aug 21, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lisa M. Bosch, DMD, LLC

  dba Knox County Dental

  • Dental Clinic/Center
  • Edina, MO
  • NPI 1780373936
  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1669588984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 N MAIN ST",
            "city": "EDINA",
            "state": "MO",
            "postal_code": "635371426",
            "telephone_number": "660-397-2213",
            "fax_number": "660-397-3929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 N MAIN ST",
            "city": "EDINA",
            "state": "MO",
            "postal_code": "635371426",
            "telephone_number": "660-397-2213",
            "fax_number": "660-397-3929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINGE",
        "first_name": "ROBERT",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "13458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Michelle Bosch, DMD
• Hannah Jo Braungardt, DO
• Angela M Bronestine, MOT, OTR/L
• Hannah Katherine Dale
• Joyce C Delaney
• HRW, Inc. (The Blessing Center)
• HRW, Inc. (The Blessing Center)
• Kirksville Missouri Hospital Company LLC (Family Health Center of Edina)

• General Practice Dentistry in Edina, MO
• Providers in Edina, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.