NPIMap

Organization Active NPI

Opdahl & Bowen DDS PC

  • Dentist
  • Independence, MO
National Provider Identifier
1790895043
Registry record updated Mar 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
015713 Issued in MO
Legal business name
OPDAHL & BOWEN DDS PC
Practice address
19201 E Valley View Pkwy
Ste a
Independence, MO 64055-6910
Phone
(816) 478-3600
Fax
(816) 478-0246
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2014

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

Authorized official

Name
Dr. Kirk J Opdahl, DDSNPI 1790806032
Title
Dentist
Phone
(816) 478-3600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 013098 MO
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 015713 MO Primary

Addresses

Primary practice location

19201 E Valley View Pkwy
Ste a
Independence, MO 64055-6910

Mailing address

19201 E Valley View Pkwy
Ste a
Independence, MO 64055-6910
Phone (816) 478-3600

Other names 1

  • Drs Elias & Opdahl DDS PC Former legal business name

National Provider Directory

National Provider Directory

Locations

19201 E Valley View Pkwy
Ste A
Independence, MO 64055
Phone (816) 478-3600

Practitioners & affiliated clinicians

Practitioners 6

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": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394668800000",
    "number": "1790895043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19201 E VALLEY VIEW PKWY",
            "address_2": "STE A",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640556910",
            "telephone_number": "816-478-3600",
            "fax_number": "816-478-0246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19201 E VALLEY VIEW PKWY",
            "address_2": "STE A",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640556910",
            "telephone_number": "816-478-3600",
            "fax_number": "816-478-0246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPDAHL & BOWEN DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2014-03-13",
        "status": "A",
        "authorized_official_last_name": "OPDAHL",
        "authorized_official_first_name": "KIRK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "816-478-3600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MO",
            "license": "013098",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MO",
            "license": "015713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Drs Elias & Opdahl DDS PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Mar 13, 2014; 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.