Individual provider Active NPI

Sara Michelle Bauer, DDS

  • General Practice Dentistry
  • Springfield, MO
National Provider Identifier
1811180185
Registry record updated Oct 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2007025304 Issued in MO
Practice address
1824 S Lone Pine Ave
Springfield, MO 65804-2610
Phone
(417) 883-2223
Fax
(471) 881-6842
NPI assigned
Aug 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2007025304 MO Primary

Addresses

Primary practice location

1824 S Lone Pine Ave
Springfield, MO 65804-2610

Mailing address

1824 S Lone Pine Ave
Springfield, MO 65804-2610
Phone (417) 883-2223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151118002916 MO Order and Referring Only - DentistPractitioner - Dentist 5799085056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2007025304MOMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444780800000",
    "number": "1811180185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 S LONE PINE AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042610",
            "telephone_number": "417-883-2223",
            "fax_number": "471-881-6842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 S LONE PINE AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042610",
            "telephone_number": "417-883-2223",
            "fax_number": "471-881-6842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUER",
        "first_name": "SARA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-21",
        "last_updated": "2015-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2007025304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.