Individual provider Active NPI

John Darrell Newman, DDS

  • General Practice Dentistry
  • Independence, MO
National Provider Identifier
1699888594
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12388 Issued in MO
Practice address
514 S Noland Rd
Ste 140
Independence, MO 64050
Phone
(816) 833-2124
Fax
(816) 833-5010
NPI assigned
Aug 16, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12388 MO Primary
General Practice Dentistry 1223G0001X 5121 KS

Addresses

Primary practice location

514 S Noland Rd
Ste 140
Independence, MO 64050

Mailing address

514 S Noland Rd
Ste 140
Independence, MO 64050
Phone (816) 833-2124

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160415000127 KS Order and Referring Only - DentistPractitioner - Dentist 9335447937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5121KSMDGeneral Practice Dentistry
12388MOMDGeneral Practice Dentistry
1521KSMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699888594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 S NOLAND RD",
            "address_2": "STE 140",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "64050",
            "telephone_number": "816-833-2124",
            "fax_number": "816-833-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 S NOLAND RD",
            "address_2": "STE 140",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "64050",
            "telephone_number": "816-833-2124",
            "fax_number": "816-833-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWMAN",
        "first_name": "JOHN",
        "middle_name": "DARRELL",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "12388",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "5121",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

Verify at the official NPI Registry.