Antioch Dental Group

Primary specialty

DentistTaxonomy code 122300000X

License

013597 Issued in MO

Legal business name

ANTIOCH DENTAL GROUP

Practice address

5420 NE Antioch Road
Kansas City, MO 64119

Phone

(816) 452-9700

Fax

(816) 452-9779

NPI assigned

Aug 20, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Fred E Bailey, DDSNPI 1003989948

Title

Owner Dentist

Phone

(816) 452-9700

Specialties & licenses 1

Addresses

Tax ID family

Antioch Dental Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Antioch Dental Group

  • General Practice Dentistry
  • Kansas City, MO
  • NPI 1336207448
  NPD tax ID

Practitioners 1

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.

• Fred E Bailey

  • Dentist
  • Kansas City, MO
  • NPI 1003989948
  Authorized official Same address or phone

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699880674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 NE ANTIOCH ROAD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64119",
            "telephone_number": "816-452-9700",
            "fax_number": "816-452-9779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5420 NE ANTIOCH ROAD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64119",
            "telephone_number": "816-452-9700",
            "fax_number": "816-452-9779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTIOCH DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "816-452-9700",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "013597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Michelle Anthony Troyer, APRN, NNP-BC
• Casey Leigh Anthony
• James P Anthony, M.D.
• Latreace Anthony, CNA
• Antioch Dental Group
• Katie Anton, PLPC
• Paula Marie Antonacci
• Richard Anthony Antunes Jr., PHARMD
• Anything Is Possible
• Rhonda Lorraine Anzawi

• Dentist in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Dentist in Missouri

• 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.