Individual provider Active NPI

Judith Nzembi Tonlaar, D.D.S

  • Dentist
  • Springfield, MO
National Provider Identifier
1861876005
Registry record updated Mar 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2016017018 Issued in MO
Practice address
2241 N Glenstone Ave
Springfield, MO 65803-4647
Phone
(417) 862-8300
NPI assigned
Jul 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901021657 MI
Dentist 122300000X 2016017018 MO Primary

Addresses

Primary practice location

2241 N Glenstone Ave
Springfield, MO 65803-4647

Mailing address

4721 S Stewart Ave
Springfield, MO 65804-7567
Phone (616) 516-8582

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2016017018MOMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1437091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1861876005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4721 S STEWART AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658047567",
            "telephone_number": "616-516-8582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2241 N GLENSTONE AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658034647",
            "telephone_number": "417-862-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TONLAAR",
        "first_name": "JUDITH",
        "middle_name": "NZEMBI",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-17",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021657",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2016017018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; 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.