Luis Fernando Missura, DMD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

61501 Issued in KS

Practice address

2541 S 4TH St
Leavenworth, KS 66048-4512

Phone

(913) 346-3636

Fax

(913) 346-3636

NPI assigned

Aug 21, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Precision Endodontics LLC

  • Endodontics
  • Leavenworth, KS
  • NPI 1427618354
  NPD (past)

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

{
    "created_epoch": "1282348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562284800000",
    "number": "1770899205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2541 S 4TH ST",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660484512",
            "telephone_number": "913-346-3636",
            "fax_number": "913-346-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2541 S 4TH ST",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660484512",
            "telephone_number": "913-346-3636",
            "fax_number": "913-346-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISSURA",
        "first_name": "LUIS",
        "middle_name": "FERNANDO",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-21",
        "last_updated": "2019-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "10235",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CO",
            "license": "DEN.00010235",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "KS",
            "license": "61501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Elisabeth Mills, PSY.D.
• Vernon A. Mills, M.D.
• Mindworx, PA
• Ivan Minnis, RN
• Adam P Misasi, MD
• Kimberly Sara Mitchell-Rajtar, MSN, RN
• Rebecca Lynn Moberly, PHD
• Kenneth Dean Moburg, CRNA
• Bailey G Moderson, AUD
• William Albert Moffitt, PHD

• Endodontics in Leavenworth, KS
• Providers in Leavenworth, KS by specialty
• Endodontics in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2019; 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.