NPIMap

Organization Active NPI

Larry D Pribyl DDS PC

  • General Practice Dentistry
  • Kansas City, MO
National Provider Identifier
1679650295
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14116 Issued in MO
Legal business name
LARRY D PRIBYL DDS PC
Practice address
4701 Logan Ave
Kansas City, MO 64136-1161
Phone
(816) 350-1007
Fax
(816) 350-1975
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Larry Dean Pribyl, DDS
Title
President
Phone
(816) 350-1007

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 14116 MO Primary

Addresses

Primary practice location

4701 Logan Ave
Kansas City, MO 64136-1161

Mailing address

4701 Logan Ave
Kansas City, MO 64136-1161
Phone (816) 350-1007

Other identifiers 1

IdentifierTypeStateIssuer
36641012OtherMOBLUE CROSS GROUP #

National Provider Directory

National Provider Directory

Locations

11644 W 75th St
Shawnee Mission, KS 66214
Phone (855) 843-5411

4437 S River Blvd
Independence, MO 64055
Phone (816) 373-8800

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679650295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 LOGAN AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641361161",
            "telephone_number": "816-350-1007",
            "fax_number": "816-350-1975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 LOGAN AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641361161",
            "telephone_number": "816-350-1007",
            "fax_number": "816-350-1975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY D PRIBYL DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRIBYL",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "816-350-1007",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "14116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP #",
            "identifier": "36641012",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.