Organization Active NPI

Kansas City Pediatric Dentistry LLC

  • Pediatric Dentistry
  • Kansas City, MO
National Provider Identifier
1912530478
Registry record updated Feb 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
KANSAS CITY PEDIATRIC DENTISTRY LLC
Practice address
3801 Southwest Trfy
Kansas City, MO 64111-2902
Phone
(816) 622-2000
Fax
(816) 298-9214
NPI assigned
Feb 12, 2020
Last updated
Feb 12, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2020

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

Authorized official

Name
Mr. Robert Drake
Title
Office Manager
Phone
(816) 622-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X NU Primary

Addresses

Primary practice location

3801 Southwest Trfy
Kansas City, MO 64111-2902

Mailing address

3801 Southwest Trfy
Kansas City, MO 64111-2902
Phone (816) 622-2000

National Provider Directory

National Provider Directory

Locations

3801 Southwest Trfy
Kansas City, MO 64111
Phone (816) 622-2000

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1581465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581465600000",
    "number": "1912530478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 SOUTHWEST TRFY",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641112902",
            "telephone_number": "816-622-2000",
            "fax_number": "816-298-9214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 SOUTHWEST TRFY",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641112902",
            "telephone_number": "816-622-2000",
            "fax_number": "816-298-9214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANSAS CITY PEDIATRIC DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-12",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A",
        "authorized_official_last_name": "DRAKE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "816-622-2000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "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 12, 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.