Individual provider Active NPI

Megan Dwyer, DENTIST

  • Dentist
  • Hannibal, MO
National Provider Identifier
1962853846
Registry record updated Mar 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2016017371 Issued in MO
Practice address
141 Communication Dr
Hannibal, MO 63401-3670
Phone
(573) 603-1460
Fax
(573) 603-1462
NPI assigned
Jun 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2016017371 MO Primary

Addresses

Primary practice location

141 Communication Dr
Hannibal, MO 63401-3670

Mailing address

118 N 2ND St
Ste 200
Saint Charles, MO 63301-2894
Phone (636) 224-1210

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2016017371MOMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520208000000",
    "number": "1962853846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 N 2ND ST",
            "address_2": "STE 200",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012894",
            "telephone_number": "636-224-1210",
            "fax_number": "636-946-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 COMMUNICATION DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634013670",
            "telephone_number": "573-603-1460",
            "fax_number": "573-603-1462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DWYER",
        "first_name": "MEGAN",
        "credential": "DENTIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-22",
        "last_updated": "2018-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2016017371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hannibal, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2018; 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.