Etheridge Complete Dentistry LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ETHERIDGE COMPLETE DENTISTRY LLC

Practice address

818 NW Park LN
Lees Summit, MO 64063-1880

Phone

(816) 525-1655

Fax

(816) 524-7800

NPI assigned

Dec 18, 2018

Organization subpart

No

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

Authorized official

Name

Dana Christian

Title

Office Manager

Phone

(816) 525-1655

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Edward Richard Haggerty Jr., DDS

  • Dentist
  • Lees Summit, MO
  • NPI 1861605867
  NPD (past)

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

{
    "created_epoch": "1545091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545091200000",
    "number": "1902378722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 NW PARK LN",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640631880",
            "telephone_number": "816-525-1655",
            "fax_number": "816-524-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 NW PARK LN",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640631880",
            "telephone_number": "816-525-1655",
            "fax_number": "816-524-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETHERIDGE COMPLETE DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-18",
        "last_updated": "2018-12-18",
        "status": "A",
        "authorized_official_last_name": "CHRISTIAN",
        "authorized_official_first_name": "DANA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "816-525-1655"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Kathryn Eskew, RD, LD
• Essential Chiropractic LLC
• Stacey Anne Estes- Juve, APRN
• Maci Louise Estes, FNP-BC
• Courtney Catherine Eswine, APRN
• Mallory Eubank, MSN, APRN-C
• Kathleen M Eubanks-Meng, D.O.
• George J Euler, DDS
• John Frederick Eurich III, MD
• Amanda Evans, PLPC

• General Practice Dentistry in Lees Summit, MO
• Providers in Lees Summit, 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 Dec 18, 2018; 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.