ETHERIDGE COMPLETE DENTISTRY LLC
NPI 1902378722
Dentist - General Practice in Lees Summit, MO

Q: What is Etheridge Complete Dentistry LLC's NPI number?

The NPI number for Etheridge Complete Dentistry LLC is 1902378722. It was assigned to this organization in the NPPES registry on December 18, 2018.

Q: What is Etheridge Complete Dentistry LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Active since December 18, 2018

818 NW PARK LN, LEES SUMMIT, MO 64063(816) 525-1655(816) 524-7800 Get Directions Write a Review

NPPES record last updated: December 18, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Etheridge Complete Dentistry Llc NPPES

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

ETHERIDGE COMPLETE DENTISTRY LLC (NPI 1902378722) is a healthcare organization registered as a general practice in Lees Summit, Missouri and active in the NPI registry since December 2018. The organization lists Dana Christian, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1902378722

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NameETHERIDGE COMPLETE DENTISTRY LLC

Location Address818 NW PARK LNLees Summit, MO 64063-1880

Mailing Address818 Nw Park LnLees Summit, MO 64063-1880 · (816) 525-1655 · Fax (816) 524-7800

Phone(816) 525-1655

Fax(816) 524-7800

Organization SubpartNo

Authorized OfficialDana ChristianOffice Manager · (816) 525-1655

Enumeration DateDecember 18, 2018

✔ NPI 1902378722 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

818 NW PARK LN, Lees Summit, MO 64063

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

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

DR. EDWARD RICHARD HAGGERTY JR. DDS

Dentist

818 NW PARK LN
LEES SUMMIT, MO 64063

Jackson County (816) 525-1655

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 Etheridge Complete Dentistry LLC's NPI number?

The NPI number for Etheridge Complete Dentistry LLC is 1902378722. It was assigned to this organization in the NPPES registry on December 18, 2018.

Where is Etheridge Complete Dentistry LLC located?

Etheridge Complete Dentistry LLC is located at 818 NW Park Ln, Lees Summit, MO 64063. The listed phone number is (816) 525-1655.

What is Etheridge Complete Dentistry LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Etheridge Complete Dentistry LLC was last updated on December 18, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.