SOUTHEAST MISSOURI HEALTH NETWORK NPI 1134340102

NPI Information

  • NPI: 1134340102
  • Provider Name: SOUTHEAST MISSOURI HEALTH NETWORK
  • Classification: Clinic/Center - 261QF0400X
  • Specialization: Federally Qualified Health Center (FQHC)
  • Entity Type: Organization
  • Doing Business As: SIKESTON DENTAL CENTER
  • Address: 220 SOUTHLAND DR
    SIKESTON, MO
    ZIP 63801
  • Phone: (573) 471-4167

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NPI Details

SOUTHEAST MISSOURI HEALTH NETWORK is a federally qualified health center (fqhc) clinic center in Sikeston, MO. SOUTHEAST MISSOURI HEALTH NETWORK NPI is 1134340102. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Sikeston Dental Center.

The provider's business location address is:

220 SOUTHLAND DR
SIKESTON, MO
ZIP 63801-403
Phone: (573) 471-4167
Fax: (573) 471-4212

The provider's authorized official is Christopher Jones .
The authorized official title is Ceo and has the following contact phone number (573) 748-2404.

The enumeration date for this NPI number is 5/1/2007 and was last updated on 7/22/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeNo
2261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11134340102OTHERMISSOURINPI
2500704069MEDICAIDMISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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