Individual provider Active NPI

Peter Henry Dotson, D.D.S.

  • Dentist
  • Kansas City, MO
National Provider Identifier
1952517328
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
012075 Issued in MO
Practice address
411 Nichols Rd
Ste 257
Kansas City, MO 64112-2000
Phone
(816) 931-3636
Fax
(816) 931-0557
NPI assigned
May 15, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 012075 MO Primary

Addresses

Primary practice location

411 Nichols Rd
Ste 257
Kansas City, MO 64112-2000

Mailing address

411 Nichols Rd
Ste 257
Kansas City, MO 64112-2000
Phone (816) 931-3636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
012075MOMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952517328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 NICHOLS RD",
            "address_2": "STE 257",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641122000",
            "telephone_number": "816-931-3636",
            "fax_number": "816-931-0557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 NICHOLS RD",
            "address_2": "STE 257",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641122000",
            "telephone_number": "816-931-3636",
            "fax_number": "816-931-0557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOTSON",
        "first_name": "PETER",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "012075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.