NPIMap

Organization Active NPI

J. Warren Hildreth, Jr DDS PC of Missouri

  • General Practice Dentistry
  • Mount Vernon, MO
National Provider Identifier
1952403040
Registry record updated Sep 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
011226 Issued in MO
Legal business name
J. WARREN HILDRETH, JR DDS PC OF MISSOURI
Practice address
1050 W Hayward Dr
Mount Vernon, MO 65712-6329
Phone
(417) 466-7184
Fax
(417) 466-4081
NPI assigned
Sep 1, 2006
Last updated
Sep 29, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2015

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

Authorized official

Name
Dr. Jay Warren Hildreth Jr., DDS
Title
Owner
Phone
(417) 466-7184

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 011226 MO Primary

Addresses

Primary practice location

1050 W Hayward Dr
Mount Vernon, MO 65712-6329

Mailing address

1050 W Hayward Dr
Mount Vernon, MO 65712-6329
Phone (417) 466-7184

Other names 1

  • J. Warren Hildreth, Jr DDS PC of MO Former legal business name

National Provider Directory

National Provider Directory

Locations

558 E Mount Vernon Blvd
Mount Vernon, MO 65712
Phone (417) 466-7196

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443484800000",
    "number": "1952403040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 W HAYWARD DR",
            "city": "MOUNT VERNON",
            "state": "MO",
            "postal_code": "657126329",
            "telephone_number": "417-466-7184",
            "fax_number": "417-466-4081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 W HAYWARD DR",
            "city": "MOUNT VERNON",
            "state": "MO",
            "postal_code": "657126329",
            "telephone_number": "417-466-7184",
            "fax_number": "417-466-4081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. WARREN HILDRETH, JR DDS PC OF MISSOURI",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-01",
        "last_updated": "2015-09-29",
        "status": "A",
        "authorized_official_last_name": "HILDRETH",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "WARREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-466-7184",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "011226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "J. Warren Hildreth, Jr DDS PC of MO",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Mount Vernon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.