Active NPI
Samantha Mayes, DDS
- Dentist
- Clinton, MO
National Provider Identifier
1811554595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2019023103
- Practice address
- 1108 E Ohio St
Clinton, MO 64735-2458 - Phone
- (660) 885-6933
- NPI assigned
- May 28, 2019
- Sex
- Female
- Sole proprietor
- No
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 | 2019023103 | MO | Primary |
Addresses
Primary practice location
1108 E Ohio St
Clinton, MO 64735-2458
Mailing address
802 Autumn Dr
Belton, MO 64012-4716
Phone (816) 679-0974
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019023103 | MO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561507200000",
"number": "1811554595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "802 AUTUMN DR",
"city": "BELTON",
"state": "MO",
"postal_code": "640124716",
"telephone_number": "816-679-0974"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1108 E OHIO ST",
"city": "CLINTON",
"state": "MO",
"postal_code": "647352458",
"telephone_number": "660-885-6933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAYES",
"first_name": "SAMANTHA",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-28",
"last_updated": "2019-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2019023103",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.