Provider Demographics
NPI:1699920470
Name:ORTHODONTICS, INC.
Entity type:Organization
Organization Name:ORTHODONTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CLARENCE
Authorized Official - Middle Name:E
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:816-753-0377
Mailing Address - Street 1:3500 NE RALPH POWELL RD STE B
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64064-2378
Mailing Address - Country:US
Mailing Address - Phone:816-317-0130
Mailing Address - Fax:816-873-1099
Practice Address - Street 1:3500 NE RALPH POWELL RD STE B
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064-2378
Practice Address - Country:US
Practice Address - Phone:816-317-0130
Practice Address - Fax:816-873-1099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-20
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0158741223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty