Active NPI
Jason R Ciminieri, DDS
- Dentist
- Leawood, KS
National Provider Identifier
1780725697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 60322
- Practice address
- 11111 Nall Ave
Suite 100
Leawood, KS 66211-1620 - Phone
- (913) 491-4900
- Fax
- (913) 491-4996
- NPI assigned
- Feb 12, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 60322 | KS | Primary |
Addresses
Primary practice location
11111 Nall Ave
Suite 100
Leawood, KS 66211-1620
Mailing address
11111 Nall Ave.
Suite 100
Leawood, KS 66211-1625
Phone (913) 491-4900
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161128000504 | KS | Order and Referring Only - Oral Surgery | 5092094524 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60322 | KS | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1780725697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11111 NALL AVE.",
"address_2": "SUITE 100",
"city": "LEAWOOD",
"state": "KS",
"postal_code": "662111625",
"telephone_number": "913-491-4900",
"fax_number": "913-491-4996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11111 NALL AVE",
"address_2": "SUITE 100",
"city": "LEAWOOD",
"state": "KS",
"postal_code": "662111620",
"telephone_number": "913-491-4900",
"fax_number": "913-491-4996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CIMINIERI",
"first_name": "JASON",
"middle_name": "R",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KS",
"license": "60322",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Leawood, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.