Albert Sohnen, DMD
Individual provider Active NPI Dentist · Richland, MO
NPI 1992836043 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1992836043
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 2003015418 (MO)
- Practice address
- 304 W Washington Ave
Richland, MO 65556-7101 - Phone
- (573) 765-5131
- Fax
- (573) 765-3122
- NPI assigned
- Mar 8, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161104001219 | PA | Order and Referring Only - Dentist |
3375821788 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2003015418 | MO | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2003015418 | MO | Yes |
Addresses
Primary practice location
304 W Washington Ave
Richland, MO 65556-7101
Mailing address
304 W Washington Ave
P.O. Box 777
Richland, MO 65556-7101
Phone (573) 765-5131
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | MO |
Other providers in Richland, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.