Summit Village Family Dental LLC
NPI 1932568060ActiveOrganization· Dentist, General Practice· Lees Summit, MO
Dentist, General Practice in Lees Summit, Missouri, registered in NPPES in February 2016. The authorized official on file is Bryan Pace, Business Manager.
Overview
| NPI | 1932568060 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 17, 2016 |
| Last updated in NPPES | Feb 17, 2016 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | 015384 | MO |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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