Individual provider Active NPI

Chad David Heath, D.D.S.

  • General Practice Dentistry
  • Warrensburg, MO
National Provider Identifier
1881626166
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2002016549 Issued in MO
Practice address
1301 Shamrock CT
Warrensburg, MO 64093-2490
Phone
(660) 747-6206
Fax
(660) 747-2615
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 2002016549 MO Primary

Addresses

Primary practice location

1301 Shamrock CT
Warrensburg, MO 64093-2490

Mailing address

615 Burkarth Rd Ste a
Warrensburg, MO 64093-1487
Phone (660) 747-6206

Other identifiers 1

IdentifierTypeStateIssuer
01615478OtherMOUNITED HEALTH CARE

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
2002016549MOMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881626166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 BURKARTH RD STE A",
            "city": "WARRENSBURG",
            "state": "MO",
            "postal_code": "640931487",
            "telephone_number": "660-747-6206",
            "fax_number": "660-747-2615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 SHAMROCK CT",
            "city": "WARRENSBURG",
            "state": "MO",
            "postal_code": "640932490",
            "telephone_number": "660-747-6206",
            "fax_number": "660-747-2615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATH",
        "first_name": "CHAD",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2002016549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "01615478",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrensburg, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.