Individual provider Active NPI

Larinda Lea Hlavacek, D.D.S.

  • Dentist
  • Kansas City, MO
National Provider Identifier
1700097839
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2007002278 Issued in MO
Practice address
650 E 25TH St
Kansas City, MO 64108-2716
Phone
(816) 235-2121
NPI assigned
May 24, 2007
Sex
Female
Sole proprietor
Yes

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2007002278 MO Primary

Addresses

Primary practice location

650 E 25TH St
Kansas City, MO 64108-2716

Mailing address

2115 W 79TH St
Prairie Village, KS 66208-3825
Phone (913) 901-8410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20160224000732 MO Order and Referring Only - DentistPractitioner - Dentist 8224333570

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2007002278MOMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700097839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 W 79TH ST",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662083825",
            "telephone_number": "913-901-8410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 E 25TH ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641082716",
            "telephone_number": "816-235-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HLAVACEK",
        "first_name": "LARINDA",
        "middle_name": "LEA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2007002278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.