Individual provider Active NPI

Edward Minor Norman, DDS

  • General Practice Dentistry
  • Lancaster, MO
National Provider Identifier
1689720732
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
014576 Issued in MO
Practice address
810 N. US Hwy 63
RT 1 Box 53
Lancaster, MO 63548-9710
Phone
(660) 457-3235
Fax
(660) 457-2110
NPI assigned
Jan 25, 2007
Last updated
Oct 22, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 014576 MO Primary

Addresses

Primary practice location

810 N. US Hwy 63
RT 1 Box 53
Lancaster, MO 63548-9710

Mailing address

810 N. U.S. Hwy. 63
211 West Madison
Lancaster, MO 63548-9710
Phone (660) 457-2010

Other identifiers 1

IdentifierTypeStateIssuer
402255806MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
014576MOMDGeneral Practice Dentistry

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1689720732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 N. U.S. HWY. 63",
            "address_2": "211 WEST MADISON",
            "city": "LANCASTER",
            "state": "MO",
            "postal_code": "635489710",
            "telephone_number": "660-457-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 N. US HWY 63",
            "address_2": "RT 1 BOX 53",
            "city": "LANCASTER",
            "state": "MO",
            "postal_code": "635489710",
            "telephone_number": "660-457-3235",
            "fax_number": "660-457-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORMAN",
        "first_name": "EDWARD",
        "middle_name": "MINOR",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "014576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "402255806",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; 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.