Individual provider Active NPI

Gregory Bruce Kivett Jr., DDS

  • General Practice Dentistry
  • Joplin, MO
National Provider Identifier
1851347843
Registry record updated Sep 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2005015022 Issued in MO
Practice address
525 W 32ND St
Joplin, MO 64804-2514
Phone
(417) 781-5600
Fax
(417) 623-5177
NPI assigned
May 25, 2006
Last updated
Sep 23, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2013

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 2005015022 MO Primary

Addresses

Primary practice location

525 W 32ND St
Joplin, MO 64804-2514

Mailing address

7301 W Hwy 86
Joplin, MO 64804-8608
Phone (417) 781-5600

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

LicenseStateTypeSpecialty
2005015022MOMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Gregory B Kivett Jr LLC Past Accepting new patients

Organizations & group practices 1

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379894400000",
    "number": "1851347843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7301 W HWY 86",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648048608",
            "telephone_number": "417-781-5600",
            "fax_number": "417-623-5177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 W 32ND ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648042514",
            "telephone_number": "417-781-5600",
            "fax_number": "417-623-5177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIVETT",
        "first_name": "GREGORY",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2013-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2005015022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; 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.