Raytown Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

RAYTOWN DENTAL

Doing business as

Comfort Dental Raytown

Practice address

8600 E 63Rd St
Raytown, MO 64133

Phone

(816) 837-4010

Fax

(816) 837-4011

NPI assigned

Oct 25, 2021

Last updated

Oct 25, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dwight Timothy Johnson, DDSNPI 1912487505

Title

Dentist

Phone

(816) 837-4010

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Comfort Dental Raytown Doing business as

Locations

Practitioners 1

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.

• Dwight Johnson

  • General Practice Dentistry
  • Grandview, MO
  • NPI 1912487505
  NPD Authorized official

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635120000000",
    "number": "1972267284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 E 63RD ST",
            "city": "RAYTOWN",
            "state": "MO",
            "postal_code": "64133",
            "telephone_number": "816-837-4010",
            "fax_number": "816-837-4011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 E 63RD ST",
            "city": "RAYTOWN",
            "state": "MO",
            "postal_code": "64133",
            "telephone_number": "816-837-4010",
            "fax_number": "816-837-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAYTOWN DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-25",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-06",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DWIGHT",
        "authorized_official_middle_name": "TIMOTHY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "816-837-4010",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400060672",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comfort Dental Raytown",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• R K Matthews Investments Inc. (Alpha & Omega 3 Private Home Health Care)
• R.D.B. Enterprises LLC
• Radiance Health & Wellness Clinic Mo-KS (Radiance Health & Wellness)
• Jennifer Ramaeker, MS, CCC-SLP
• Melanie Alexis Ramos-Green, MA
• Raytown Dental LLC (Comfort Dental Raytown)
• Raytown Dental PLLC
• Raytown Dentist, LLC
• Raytown Health Care LLC (Autumn Terrace Health & Rehabilitation)
• Raytown Opco LLC (Trustwell Living of Raytown)

• Dental Clinic/Center in Raytown, MO
• Providers in Raytown, MO by specialty
• Dental Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; 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.