NPIMap

Organization Active NPI

Deer Creek Family Dental

  • General Practice Dentistry
  • Overland Park, KS
National Provider Identifier
1992878987
Registry record updated Apr 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5872 Issued in KS
Legal business name
DEER CREEK FAMILY DENTAL
Practice address
13328 Metcalf Ave
Overland Park, KS 66213-2804
Phone
(913) 345-2273
Fax
(913) 345-8102
NPI assigned
Nov 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2014

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

Authorized official

Name
Dr. Jahn Roedemeier, D.D.S.NPI 1063594083
Title
Owner
Phone
(913) 345-2273

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 5872 KS Primary

Addresses

Primary practice location

13328 Metcalf Ave
Overland Park, KS 66213-2804

Mailing address

13328 Metcalf Ave
Overland Park, KS 66213-2804
Phone (913) 345-2273

National Provider Directory

National Provider Directory

Locations

13328 Metcalf Ave
Overland Park, KS 66213
Phone (913) 345-2273

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397433600000",
    "number": "1992878987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13328 METCALF AVE",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662132804",
            "telephone_number": "913-345-2273",
            "fax_number": "913-345-8102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13328 METCALF AVE",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662132804",
            "telephone_number": "913-345-2273",
            "fax_number": "913-345-8102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEER CREEK FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2014-04-14",
        "status": "A",
        "authorized_official_last_name": "ROEDEMEIER",
        "authorized_official_first_name": "JAHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "913-345-2273",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "5872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2014; 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.