Lakewood Oral and Maxillofacial Surgery Specialists

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

2008034915 Issued in MO

Legal business name

LAKEWOOD ORAL AND MAXILLOFACIAL SURGERY SPECIALISTS

Practice address

3600 NE Ralph Powell Rd
Suite D
Lees Summit, MO 64064-2369

Phone

(816) 554-8300

Fax

(816) 554-8303

NPI assigned

Aug 29, 2011

Last updated

Aug 29, 2011By 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

Dr. Christopher J Haggerty, DDS, MDNPI 1629244959

Title

Member

Phone

(816) 554-8300

Specialties & licenses 4

Addresses

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.

• Christopher John Haggerty, DDS, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Lee's Summit, MO
  • NPI 1629244959
  Authorized official Same address or phone

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

{
    "created_epoch": "1314576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314576000000",
    "number": "1730460270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 NE RALPH POWELL RD",
            "address_2": "SUITE D",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640642369",
            "telephone_number": "816-554-8300",
            "fax_number": "816-554-8303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 NE RALPH POWELL RD",
            "address_2": "SUITE D",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640642369",
            "telephone_number": "816-554-8300",
            "fax_number": "816-554-8303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEWOOD ORAL AND MAXILLOFACIAL SURGERY SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-29",
        "last_updated": "2011-08-29",
        "status": "A",
        "authorized_official_last_name": "HAGGERTY",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "816-554-8300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "2002013152",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "KS",
            "license": "60577",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MO",
            "license": "2008034915",
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "KS",
            "license": "04-34622",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lakewood Care Center (Wilshire at Lakewood)
• Lakewood Care Center of Lee's Summit, L.C. (Wilshire at Lakewood)
• Lakewood Chiropractic P.C.
• Lakewood Chiropractic, P.C.
• Lakewood Healing Hands
• Lakewood Psychological Services P.C.
• Destiny P Lakin, MED, LPC
• Lally Vision Care, P.C.
• Steven Eric Lally, O.D.
• Tron Yuri Lally, O.D.

• Oral & Maxillofacial Surgery (D.M.D.) in Lee's Summit, MO
• Providers in Lee's Summit, MO by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2011; 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.