Active NPI
Daniel Cusumano, DDS
- Dentist
- Kansas City, MO
National Provider Identifier
1871032458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2017002811
- Practice address
- 650 E 25TH St
Kansas City, MO 64108-2716 - Phone
- (816) 235-2121
- NPI assigned
- Feb 16, 2017
- Last updated
- Feb 16, 2017
- Sex
- Male
- 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 | 2017002811 | MO | Primary |
Addresses
Primary practice location
650 E 25TH St
Kansas City, MO 64108-2716
Mailing address
619 E Armour Blvd Apt 408
Kansas City, MO 64109-2297
Phone (314) 960-4216
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 |
|---|---|---|---|
| 2017002811 | MO | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Dentistry of O'Fallon LLC | Current | 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.
-
dba Advanced Dentistry of O'Fallon
- General Practice Dentistry
- O'Fallon, MO
- NPI 1750176103
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487203200000",
"number": "1871032458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "619 E ARMOUR BLVD APT 408",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641092297",
"telephone_number": "314-960-4216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 E 25TH ST",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641082716",
"telephone_number": "816-235-2121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUSUMANO",
"first_name": "DANIEL",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-02-16",
"last_updated": "2017-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2017002811",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kansas City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.