J. Warren Hildreth, Jr DDS PC of Missouri

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

J. WARREN HILDRETH, JR DDS PC OF MISSOURI

Practice address

558 E Mount Vernon Blvd
Mount Vernon, MO 65712-2102

Phone

(417) 466-7196

Fax

(417) 466-2129

NPI assigned

Jun 16, 2015

Last updated

Jun 16, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Brian George

Title

Ceo

Phone

(417) 466-7196

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434412800000",
    "number": "1942681994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "558 E MOUNT VERNON BLVD",
            "city": "MOUNT VERNON",
            "state": "MO",
            "postal_code": "657122102",
            "telephone_number": "417-466-7196",
            "fax_number": "417-466-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "558 E MOUNT VERNON BLVD",
            "city": "MOUNT VERNON",
            "state": "MO",
            "postal_code": "657122102",
            "telephone_number": "417-466-7196",
            "fax_number": "417-466-2129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. WARREN HILDRETH, JR DDS PC OF MISSOURI",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-16",
        "last_updated": "2015-06-16",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "417-466-7196",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hazel Mae Hupeda Hofilena, RPT
• Kelsey Hoover, LMT
• Cheryl Denise Howard, PHARM.D.
• Emily Renee Huey
• Frederick Crumpacker Husted, M.D.
• J. Warren Hildreth, Jr DDS PC of Missouri
• Donna Jackson, RDH
• JB Evans & Associates LLC (Caring Hearts Homecare Of Southwest MO)
• Justin Jenkins
• Teresa Barr Jolley, PA-C

• General Practice Dentistry in Mount Vernon, MO
• Providers in Mount Vernon, 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 Jun 16, 2015; 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.