Individual provider Active NPI

Benjamin Scott Sanley, D.D.S

  • Dentist
  • Independence, MO
National Provider Identifier
1831395094
Registry record updated Apr 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2007014549 Issued in MO
Practice address
19401 E Valley View Pkwy
Independence, MO 64055-6936
Phone
(816) 795-6325
NPI assigned
Jun 25, 2007
Last updated
Apr 6, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2007014549 MO Primary

Addresses

Primary practice location

19401 E Valley View Pkwy
Independence, MO 64055-6936

Mailing address

19401 E Valley View Pkwy
Independence, MO 64055-6936
Phone (816) 795-6325

Other identifiers 1

IdentifierTypeStateIssuer
2204349-01MedicaidTX

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
I20221206000909 MO Practitioner - Dentist 0648568840 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Samuel U. Rodgers Health Center, Inc CurrentSince Nov 28, 2022 Accepting new patients
Samuel U. Rodgers Health Center, Inc. CurrentSince Nov 28, 2022 Accepting new patients
Kirby J. Robinson, DDS of Missouri, LLC PastSince Jun 21, 2022 Accepting new patients
Anthony F. Williams, DDS, P.C. Dentist Past Accepting new patients

Locations

825 Euclid Ave
Kansas City, MO 64124
Phone (816) 889-4816

800 Haines
Liberty, MO 64068
Phone (816) 595-4200

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459900800000",
    "number": "1831395094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19401 E VALLEY VIEW PKWY",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640556936",
            "telephone_number": "816-795-6325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19401 E VALLEY VIEW PKWY",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640556936",
            "telephone_number": "816-795-6325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANLEY",
        "first_name": "BENJAMIN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-25",
        "last_updated": "2016-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2007014549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2204349-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

Verify at the official NPI Registry.