MR. MATTHEW R HLAVACEK (NPI# 1285613240) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1285613240 |
Entity Type | Individual |
Full Name | MR. MATTHEW R HLAVACEK |
Credential | MD, DDS |
Practice Address |
1208 Ne Windsor Dr Lees Summit MO 64086-5594 |
Practice Telephone | 8165244334 |
Practice Fax Number | 8165244399 |
Mailing Telephone | 8165244334 |
Mailing Fax Number | 8165244399 |
Enumeration Date | 2006-01-10 |
Last Update Date | 2012-07-30 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 122300000X | Dentist | 016083 | MO | Dental Providers |
N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
016083 | MO | Dental Providers |
Y | 204E00000X | Oral & Maxillofacial Surgery | 2005027155 | MO | Allopathic & Osteopathic Physicians |
N | 208D00000X | General Practice | 2005027155 | MO | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MO | 404017105 | 05 | |
MO | 204017107 | 05 |
Street Address |
1208 NE WINDSOR DR |
City | LEES SUMMIT |
State | MO |
Zip Code | 64086-5594 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699861906 | Facial Spectrum Inc | Dentist | 1208 Ne Windsor Dr, Lees Summit, MO 64086-5594 | 2006-10-05 |
1588626659 | Steven J Prstojevich | Dentist | 1208 Ne Windsor Dr, Lees Summit, MO 64086-5594 | 2006-04-04 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740821057 | David L Harrison | Pharmacist | 6 Nw Sycamore St Ste A, Lees Summit, MO 64086 | 2019-10-08 |
1770069403 | Foster Family Pharmacy | Pharmacy | 6 Nw Sycamore St., Suite A, Lee's Summit, MO 64086 | 2018-07-16 |
1255716221 | Summit Eye Center, LLC | Ophthalmology | 1621 Nw Blue Parkway, Lees Summit, MO 64086 | 2015-07-20 |
1679954085 | Day By Day Staff Relief, LLC | Hospice Care, Community Based | 943 Ne Columbus Street, Lees Summit, MO 64086 | 2015-06-11 |
1831505544 | Johnathan Almeida | Emergency Medicine | 100 Ne St Lukes Blvd, Emergency Department, Lees Summit, MO 64086 | 2014-07-02 |
1215358429 | Alex Sharifian Dds Summit Modern Dentistry PC | Dentist | 940 Nw Blue Parkway, Suite A, Lee's Summit, MO 64086 | 2013-12-16 |
1477807303 | Lauren M Lee | Nurse Practitioner | 1425 Nw Blue Parkway, Lee's Summit, MO 64086 | 2012-10-30 |
1396016507 | Retha Rene Rudloff | General Practice | 1728 N.e. Misty Lane, Lee's Summit, MO 64086 | 2012-01-19 |
1629351200 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 691 Nw Blue Pkwy, Lees Summit, MO 64086 | 2011-09-21 |
1497054308 | Jennifer Nelson | Physical Therapist | 301 Ne Tudor, Lee's Summit, MO 64086 | 2011-03-17 |
Find all providers in zip 64086 |
Taxonomy Code | 204E00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Oral & Maxillofacial Surgery |
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609162189 | Rebecca Lindsay Grammer | Oral & Maxillofacial Surgery | 1034 S. Brentwood, Suite 1010, St. Louis, MO 63117-1210 | 2011-06-23 |
1659538973 | Michael J Pernoud Dds PC | Oral & Maxillofacial Surgery | 1015 Washington Sq Ste F, Washington, MO 63090-5307 | 2008-05-22 |
1912173592 | John O'connor Heiman | Oral & Maxillofacial Surgery | 4545 Wornall Rd, # 608, Kansas City, MO 64111-3270 | 2008-05-05 |
1730222647 | Matthew W Sheffer | Oral & Maxillofacial Surgery | 5227 S Main St Ste B, Joplin, MO 64804-4938 | 2007-02-14 |
1558415075 | Roberet L Ward | Oral & Maxillofacial Surgery | 1325 N Mt Auburn Rd, Cape Giraedeau, MO 63701 | 2007-01-22 |
1790849834 | Edward Steven Czebrinski | Oral & Maxillofacial Surgery | 77 Westport Plaza Medical Center, Suite 356, Saint Louis, MO 63146 | 2006-12-21 |
1063593838 | Eugenio G Herbosa | Oral & Maxillofacial Surgery | 12818 Tesson Ferry Road, Suite 204, St Louis, MO 63128 | 2006-10-18 |
1912019290 | David M Ivey Dds PC | Oral & Maxillofacial Surgery | One Mid Rivers Mall Dr, Ste 310, St Peters, MO 63376-4323 | 2006-08-31 |
1285017806 | Marion Harris | Oral & Maxillofacial Surgery | 2301 Holmes St, Kansas City, MO 64108-2640 | 2015-06-30 |
1851618847 | Aosdi, Glenn J Makowski, Dmd, Md, PC | Oral & Maxillofacial Surgery | 2602 Cunningham Ave, Joplin, MO 64804-1542 | 2010-04-29 |
Find all providers with the same taxonomy |
City | LEES SUMMIT |
Zip Code | 64086 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.