Blair Edgington

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2009008936 Issued in MO

Practice address

4121 W 83Rd St
Ste 137
Prairie Village, KS 66208-5323

Phone

(913) 381-4700

Fax

(913) 381-2673

NPI assigned

Jun 5, 2008

Last updated

Jun 28, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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.

• Village Complete Dentistry, LLC

  • Dental Clinic/Center
  • Prairie Village, KS
  • NPI 1811571896
  Medicare reassignment
• Dr. Steven C. Mingos & Associates, LLC

  • General Practice Dentistry
  • Kansas City, MO
  • NPI 1912029893
  NPD (past)

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1689833519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4121 W 83RD ST",
            "address_2": "STE 137",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662085323",
            "telephone_number": "913-381-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 W 83RD ST",
            "address_2": "STE 137",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662085323",
            "telephone_number": "913-381-4700",
            "fax_number": "913-381-2673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDGINGTON",
        "first_name": "BLAIR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-05",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "60554",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2009008936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica M Duvall, DPT
• Catherine Dyck, LMFT
• Trinity Dye
• Diane Dyer-Chenoweth, D.D.S.
• E Kent Stevenson MD PC
• Cara Christine Edwards
• Julie Edwards, M.S., CCC-SLP
• Christopher Jay Ehly, MD
• Catherine A Eib, APRN
• McKenna Elfrink

• General Practice Dentistry in Prairie Village, KS
• Providers in Prairie Village, KS by specialty
• General Practice Dentistry in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.