Organization Active NPI

Haywood L Hambrick, D.D.S. Inc

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Kansas City, MO
National Provider Identifier
1790950582
Registry record updated Apr 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
012136 / 591 Issued in MO
Legal business name
HAYWOOD L HAMBRICK, D.D.S. INC
Practice address
1115 East 65TH Street
Kansas City, MO 64131-1202
Phone
(816) 523-7766
Fax
(816) 523-2263
NPI assigned
Apr 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2008

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

Authorized official

Name
Dr. Haywood Lee Hambrick, D D SNPI 1447386206
Title
Owner
Phone
(816) 523-7766

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 012136 / 591 MO Primary

Addresses

Primary practice location

1115 East 65TH Street
Kansas City, MO 64131-1202

Mailing address

1115 E 65TH St
Kansas City, MO 64131-1202
Phone (816) 523-7766

Other identifiers 3

IdentifierTypeStateIssuer
2181OtherMODORAL
609100OtherMOBRIDGEPORT
400750402MedicaidMO

National Provider Directory

National Provider Directory

Locations

1115 E 65th St
Kansas City, MO 64131
Phone (816) 444-9091

Practitioners & affiliated clinicians

Practitioners 2

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": "1208908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208908800000",
    "number": "1790950582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 E 65TH ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641311202",
            "telephone_number": "816-523-7766",
            "fax_number": "816-523-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 EAST 65TH STREET",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641311202",
            "telephone_number": "816-523-7766",
            "fax_number": "816-523-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAYWOOD L HAMBRICK, D.D.S. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-23",
        "last_updated": "2008-04-23",
        "status": "A",
        "authorized_official_last_name": "HAMBRICK",
        "authorized_official_first_name": "HAYWOOD",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "816-523-7766",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D D S"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MO",
            "license": "012136         / 591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL",
            "identifier": "2181",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRIDGEPORT",
            "identifier": "609100",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400750402",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; 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.