NPIMap

Organization Active NPI

Eastland Family Dental, LLC

  • General Practice Dentistry
  • Independence, MO
National Provider Identifier
1730401738
Registry record updated Feb 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2003011849 Issued in MO
Legal business name
EASTLAND FAMILY DENTAL, LLC
Practice address
19401 E 40 Hwy
Suite 180
Independence, MO 64055-5450
Phone
(816) 795-7007
Fax
(816) 795-7073
NPI assigned
Feb 18, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2010

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

Authorized official

Name
Dr. James Eric Moore, DDS
Title
Owner
Phone
(816) 795-7007

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 2003011849 MO Primary

Addresses

Primary practice location

19401 E 40 Hwy
Suite 180
Independence, MO 64055-5450

Mailing address

19401 E 40 Hwy
Suite 180
Independence, MO 64055-5450
Phone (816) 795-7007

National Provider Directory

National Provider Directory

Locations

19401 E US Highway 40
Ste 180
Independence, MO 64055
Phone (816) 795-7007

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1266451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266451200000",
    "number": "1730401738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19401 E 40 HWY",
            "address_2": "SUITE 180",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640555450",
            "telephone_number": "816-795-7007",
            "fax_number": "816-795-7073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19401 E 40 HWY",
            "address_2": "SUITE 180",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640555450",
            "telephone_number": "816-795-7007",
            "fax_number": "816-795-7073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTLAND FAMILY DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-18",
        "last_updated": "2010-02-18",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "816-795-7007",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2003011849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2010; 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.