Active NPI
Hannibal Dental Group
- General Practice Dentistry
- Hannibal, MO
National Provider Identifier
1699745935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 9881
- Legal business name
- HANNIBAL DENTAL GROUP
- Practice address
- 2727 Saint Marys Ave
Hannibal, MO 63401-3774 - Phone
- (573) 221-1227
- Fax
- (573) 221-5564
- NPI assigned
- Jan 26, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Vicki L Luebrecht
- Title
- Office Manager
- Phone
- (573) 221-1227
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 9881 | MO | Primary |
Addresses
Primary practice location
2727 Saint Marys Ave
Hannibal, MO 63401-3774
Mailing address
2727 Saint Marys Ave
Hannibal, MO 63401-3774
Phone (573) 221-1227
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 501174 | Other | MO | INSURANCE |
| 501065 | Other | MO | INSURANCE |
| 818028 | Other | MO | INSURANCE |
| 501160 | Other | MO | INSURANCE |
| 74007199 | Other | MO | INSURANCE |
| 409534 | Other | MO | INSURANCE |
| 409535 | Other | MO | INSURANCE |
| 74014433 | Other | MO | INSURANCE |
| 74014632 | Other | MO | INSURANCE |
| 74017142 | Other | MO | INSURANCE |
| M00100 | Other | MO | INSURANCE |
National Provider Directory
National Provider DirectoryLocations
2727 Saint Marys Ave
Hannibal, MO 63401
Phone (573) 221-1227
Practitioners & affiliated clinicians
Practitioners 8
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Dentist
- Hannibal, MO
- NPI 1326530510
-
- General Practice Dentistry
- Hannibai, MO
- NPI 1497323240
General Practice
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138233600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1699745935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2727 SAINT MARYS AVE",
"city": "HANNIBAL",
"state": "MO",
"postal_code": "634013774",
"telephone_number": "573-221-1227",
"fax_number": "573-221-5564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2727 SAINT MARYS AVE",
"city": "HANNIBAL",
"state": "MO",
"postal_code": "634013774",
"telephone_number": "573-221-1227",
"fax_number": "573-221-5564"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HANNIBAL DENTAL GROUP",
"organizational_subpart": "NO",
"enumeration_date": "2006-01-26",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "LUEBRECHT",
"authorized_official_first_name": "VICKI",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "573-221-1227",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "MO",
"license": "9881",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INSURANCE",
"identifier": "501174",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INSURANCE",
"identifier": "501065",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INSURANCE",
"identifier": "818028",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INSURANCE",
"identifier": "501160",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INSURANCE",
"identifier": "74007199",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INSURANCE",
"identifier": "409534",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INSURANCE",
"identifier": "409535",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INSURANCE",
"identifier": "74014433",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INSURANCE",
"identifier": "74014632",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INSURANCE",
"identifier": "74017142",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INSURANCE",
"identifier": "M00100",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hannibal, MO
- Hannibal Clinic Operations, L.L.C.
- Hannibal Council on Alcohol & Drug Abuse
- Hannibal Council on Alcohol & Drug Abuse
- Hannibal Council on Alcohol & Drug Abuse
- Hannibal Council on Alcohol and Drug Abuse
- Hannibal Health & Rehabilitation Center, Inc.
- Hannibal Medical Supplies, LLC
- Hannibal Mobile Diagnostics, LLC
- Hannibal Regional Healthcare System Inc
- Hannibal Regional Healthcare System Inc
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.