NPIMap

Organization Active NPI

RM Dental Group East

  • Dentist
  • Kansas City, MO
National Provider Identifier
1972040699
Registry record updated Jan 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2010016286 Issued in MO
Legal business name
RM DENTAL GROUP EAST
Practice address
4516 Broadway
Unit 301
Kansas City, MO 64111-3381
Phone
(573) 230-6862
NPI assigned
Jan 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2017

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

Authorized official

Name
Dr. Peter Benjamin McClellan, DDS
Title
Owner Dentist
Phone
(573) 230-6862

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 2010016286 MO Primary

Addresses

Primary practice location

4516 Broadway
Unit 301
Kansas City, MO 64111-3381

Mailing address

655 R D Mize Rd.
Grain Valley, MO 64029
Phone (816) 229-4560

Other names 1

  • Grain Valley Family Dental Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1484870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484870400000",
    "number": "1972040699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 R D MIZE RD.",
            "city": "GRAIN VALLEY",
            "state": "MO",
            "postal_code": "64029",
            "telephone_number": "816-229-4560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4516 BROADWAY",
            "address_2": "UNIT 301",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641113381",
            "telephone_number": "573-230-6862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RM DENTAL GROUP EAST",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-20",
        "last_updated": "2017-01-20",
        "status": "A",
        "authorized_official_last_name": "MCCLELLAN",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "573-230-6862",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MO",
            "license": "2010016286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grain Valley Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 20, 2017; 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.