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BOOTHEEL DENTAL CLINIC
NPI 1457570681
Clinic/Center - Federally Qualified Health Center (FQHC) in New Madrid, MO

Active since April 25, 2007
202B MAIN ST, NEW MADRID, MO 63869(573) 748-5671(573) 748-5317 Get Directions Write a Review

NPPES record last updated: July 22, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Bootheel Dental Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BOOTHEEL DENTAL CLINIC (NPI 1457570681) is a healthcare organization registered as a federally qualified health center (fqhc) in New Madrid, Missouri and active in the NPI registry since April 2007. The organization lists Christopher Jones, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1457570681
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameSOUTHEAST MISSOURI HEALTH NETWORK
Location Address202B MAIN STNew Madrid, MO 63869-1911
Mailing Address420 Semo Dr, P.o. Box 400New Madrid, MO 63869-1734 · (573) 748-2404 · Fax (573) 748-8929
Phone(573) 748-5671
Fax(573) 748-5317
Organization SubpartYes
Authorized OfficialChristopher JonesChief Executive Officer · (573) 748-2404
Enumeration DateApril 25, 2007
Last NPPES UpdateJuly 22, 2014
✔ NPI 1457570681 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
Also ListedDentist · General PracticeTaxonomy 1223G0001X
202B MAIN ST, New Madrid, MO 63869
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Other Names 1

Doing Business AsBootheel Dental Clinic

Other Identifiers 1

Medicaid500704069MO

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KRISTEN NELSON DENTAL HYGENTIST
Dental Hygienist
202B MAIN ST
NEW MADRID, MO 63869
New Madrid County (573) 748-5671
CARRIE L GREGORY DENTAL HYGENTIST
Dental Hygienist
202B MAIN ST
NEW MADRID, MO 63869
New Madrid County (573) 748-5671
BLAIR RAY DENTAL HYGENIST
Dental Hygienist
202B MAIN ST
NEW MADRID, MO 63869
New Madrid County (573) 748-5671

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southeast Missouri Health Network's NPI number?

The NPI number for Southeast Missouri Health Network is 1457570681. It was assigned to this organization in the NPPES registry on April 25, 2007. The provider is doing business as Bootheel Dental Clinic.

Where is Southeast Missouri Health Network located?

Southeast Missouri Health Network is located at 202B Main St, New Madrid, MO 63869. The listed phone number is (573) 748-5671.

What is Southeast Missouri Health Network's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

When was this NPI record last updated?

The NPPES record for Southeast Missouri Health Network was last updated on July 22, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.