Individual provider Active NPI

Michelle G McHale

  • Dentist
  • Overland Park, KS
National Provider Identifier
1932466851
Registry record updated Jun 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
61145 Issued in KS
Practice address
4601 W 109TH St
Suite #212
Overland Park, KS 66211-1318
Phone
(913) 954-4174
NPI assigned
Apr 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Periodontics 1223P0300X 2016015261 MO
Dentist 122300000X D13101 MN
Dentist 122300000X 61145 KS Primary

Addresses

Primary practice location

4601 W 109TH St
Suite #212
Overland Park, KS 66211-1318

Mailing address

3965 W 83Rd St
#268
Prairie Village, KS 66208-5308
Phone (612) 396-8842

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 1, 2017 through Jan 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D13101MNMDDentist
2016015261MOMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Specialty Anesthesia LLC Past Accepting new patients
Edwards & Wilson Periodontics, PA Periodontics Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1334620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466035200000",
    "number": "1932466851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3965 W 83RD ST",
            "address_2": "#268",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662085308",
            "telephone_number": "612-396-8842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 W 109TH ST",
            "address_2": "SUITE #212",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111318",
            "telephone_number": "913-954-4174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCHALE",
        "first_name": "MICHELLE",
        "middle_name": "G",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-17",
        "last_updated": "2016-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MO",
            "license": "2016015261",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13101",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KS",
            "license": "61145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.