NPIMap

Organization Active NPI

J.Warren Hildreth, Jr., DDS PA

Doing business as St. Marys Dental Center

  • General Practice Dentistry
  • Saint Marys, KS
National Provider Identifier
1962782680
Registry record updated Aug 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4680 Issued in KS
Legal business name
J.WARREN HILDRETH, JR., DDS PA
Doing business as
St. Marys Dental Center
Practice address
310 W Bertrand Ave
Saint Marys, KS 66536-1615
Phone
(785) 437-2771
Fax
(785) 321-1773
NPI assigned
Aug 25, 2011
Last updated
Aug 25, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2011

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
President
Phone
(785) 456-7083

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4680 KS Primary

Addresses

Primary practice location

310 W Bertrand Ave
Saint Marys, KS 66536-1615

Mailing address

310 W Bertrand Ave
Saint Marys, KS 66536-1615
Phone (785) 456-7083

Other names 1

  • St. Marys Dental Center Doing business as

National Provider Directory

National Provider Directory

Locations

310 W Bertrand Ave
Saint Marys, KS 66536
Phone (762) 254-1400

Practitioners & affiliated clinicians

Practitioners 3

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": "1314230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314230400000",
    "number": "1962782680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 W BERTRAND AVE",
            "city": "SAINT MARYS",
            "state": "KS",
            "postal_code": "665361615",
            "telephone_number": "785-456-7083",
            "fax_number": "785-456-6520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 W BERTRAND AVE",
            "city": "SAINT MARYS",
            "state": "KS",
            "postal_code": "665361615",
            "telephone_number": "785-437-2771",
            "fax_number": "785-321-1773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J.WARREN HILDRETH, JR., DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-25",
        "last_updated": "2011-08-25",
        "status": "A",
        "authorized_official_last_name": "HILDRETH",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "WARREN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "785-456-7083",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "4680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Marys Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Marys, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2011; 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.