SOUTHEAST MISSOURI HEALTH NETWORK NPI 1134340102

NPI Information

NPI: 1134340102
Provider Name: SOUTHEAST MISSOURI HEALTH NETWORK

Doing Business As: SIKESTON DENTAL CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
220 SOUTHLAND DR
SIKESTON, MO
ZIP 63801
Phone: (573) 471-4167
Get Directions

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
1	1223G0001X	Dentist	General Practice			No
2	261QF0400X	Clinic/Center	Federally 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
1	1134340102	OTHER	MISSOURI	NPI
2	500704069	MEDICAID	MISSOURI

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: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »