NPIMap

Organization Active NPI

Cherry Hill Dental Associates Inc

  • Dentist
  • Jefferson City, MO
National Provider Identifier
1942751086
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2000158124 Issued in MO
Legal business name
CHERRY HILL DENTAL ASSOCIATES INC
Practice address
923 S Country Club Dr
Jefferson City, MO 65109-0352
Phone
(573) 556-8500
NPI assigned
Oct 24, 2016
Last updated
Sep 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Authorized official

Name
Dr. Mary Virginia Gadbois, DDSNPI 1679783591
Title
Owner/Dentist
Phone
(573) 446-0880

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X 2000158124 MO
Dentist 122300000X 2000158124 MO Primary

Addresses

Primary practice location

923 S Country Club Dr
Jefferson City, MO 65109-0352

Mailing address

220 Diego Dr Ste 201
Columbia, MO 65203-4923
Phone (573) 356-9967

National Provider Directory

National Provider Directory

Locations

220 Diego Dr
Ste 201
Columbia, MO 65203
Phone (573) 446-0880

923 S Country Club Dr
Jefferson City, MO 65109
Phone (573) 446-0880

Practitioners & affiliated clinicians

Practitioners 6

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": "1477267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725321600000",
    "number": "1942751086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 DIEGO DR STE 201",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652034923",
            "telephone_number": "573-356-9967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 S COUNTRY CLUB DR",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651090352",
            "telephone_number": "573-556-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHERRY HILL DENTAL ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-24",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A",
        "authorized_official_last_name": "GADBOIS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "VIRGINIA",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "573-446-0880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "MO",
            "license": "2000158124",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2000158124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; 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.