Personal Care Dental Group LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PERSONAL CARE DENTAL GROUP LLC

Practice address

9500 E 63Rd Street
Ste # 103
Raytown, MO 64133

Phone

(816) 737-1110

Fax

(816) 356-9005

NPI assigned

Oct 25, 2006

Organization subpart

No

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

Authorized official

Name

Jennifer L Johnson

Title

Co Office Manager

Phone

(816) 737-1110

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christopher Barreca, DDS

  • General Practice Dentistry
  • Raytown, MO
  • NPI 1588768782
  NPD (past)
• Rubelita James, DDS

  • General Practice Dentistry
  • Raytown, MO
  • NPI 1023112380
  NPD (past)
• Pamela A Richardson, DDS

  • General Practice Dentistry
  • Raytown, MO
  • NPI 1144324344
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861576902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 E 63RD STREET",
            "address_2": "STE # 103",
            "city": "RAYTOWN",
            "state": "MO",
            "postal_code": "64133",
            "telephone_number": "816-737-1110",
            "fax_number": "816-356-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 E 63RD STREET",
            "address_2": "STE # 103",
            "city": "RAYTOWN",
            "state": "MO",
            "postal_code": "64133",
            "telephone_number": "816-737-1110",
            "fax_number": "816-356-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONAL CARE DENTAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CO OFFICE MANAGER",
        "authorized_official_telephone_number": "816-737-1110"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven L Padget, O.D.
• Willie Lee Parker III, DPT
• Michael Eugene Patterson, LPC
• Delia Ana Pearl
• Jessica Peavler
• Phem, LLC
• Joseph Robert Pleasant, DDS
• Anna Pomeroy, LMSW
• Delainey Pospichal
• Premise Health of Missouri Medical PC

• General Practice Dentistry in Raytown, MO
• Providers in Raytown, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.