Individual provider Active NPI

Scott Alan Roberson, DDS

  • General Practice Dentistry
  • Independence, MO
National Provider Identifier
1922003482
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
013151 Issued in MO
Practice address
3220 S M-291 Hwy
Independence, MO 64057-1702
Phone
(816) 350-0808
Fax
(816) 350-9300
NPI assigned
Jun 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 013151 MO Primary

Addresses

Primary practice location

3220 S M-291 Hwy
Independence, MO 64057-1702

Mailing address

3220 S M-291 Hwy
Independence, MO 64057-1702
Phone (816) 350-0808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160311001157 MO Order and Referring Only - DentistPractitioner - Dentist 2961708201

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1922003482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 S M-291 HWY",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640571702",
            "telephone_number": "816-350-0808",
            "fax_number": "816-350-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 S M-291 HWY",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640571702",
            "telephone_number": "816-350-0808",
            "fax_number": "816-350-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "SCOTT",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "013151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

Verify at the official NPI Registry.