Pacific Dental Center

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PACIFIC DENTAL CENTER

Practice address

305 E Osage St Ste 3
Pacific, MO 63069-1621

Phone

(636) 257-3997

NPI assigned

Apr 24, 2022

Last updated

Apr 27, 2022By 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

Carl Graves, DDSNPI 1295188761

Title

DDS

Phone

(850) 712-2307

Specialties & licenses 1

Addresses

Locations

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.

• Carl Stephen Graves, D.D.S.

  • Dentist
  • Fort Walton Beach, FL
  • NPI 1295188761
  NPD Authorized official

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

{
    "created_epoch": "1650758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651017600000",
    "number": "1790429983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 LAKELAND DR",
            "city": "PACIFIC",
            "state": "MO",
            "postal_code": "630691076",
            "telephone_number": "850-712-2307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 E OSAGE ST STE 3",
            "city": "PACIFIC",
            "state": "MO",
            "postal_code": "630691621",
            "telephone_number": "636-257-3997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-24",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A",
        "authorized_official_last_name": "GRAVES",
        "authorized_official_first_name": "CARL",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "850-712-2307",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Ann Niehoo, P.T.
• Kayla Marie O'Daniel, PHARMD
• Christopher Max Orris, D.C.
• Pacific Care Center LLC
• Pacific Chiropractic Center, LLC
• Pacific Manor LLC (Pacific Manor)
• Pacific RX Inc (Medicine Shoppe)
• Hetal Mahendra Patel
• Patients First Health Care LLC
• Paul R Lumpkin Jr DC Chiropractor Inc (Paul R Lumpkin DC PC)

• Dental Clinic/Center in Pacific, MO
• Providers in Pacific, MO by specialty
• Dental Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; 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.