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Contact Information

MISSOURI DENTAL SPECIALISTS
1002 DIAMOND RDG STE 1500
JEFFERSON CITY, MO65109-7914
 Phone: 573-298-4400
 Fax: 573-616-1489
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Endodontics

1223E0200X
 

Periodontics

1223P0300X
Indicates primary specialty

NPI Profile & details for MISSOURI DENTAL SPECIALISTS

NPI Number 1518427079
LBN Legal business name MISSOURI DENTAL SPECIALISTS
Authorized official EDNA LIVINGSTON - (PRACTICE MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 03/21/2019
Last updated 05/21/2020 - About 6 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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