Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

South Independence Dental LLC

Organization Dentist · NPI 1245842202

South Independence Dental LLC is a Dentist in Independence, Missouri. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12400 E 40 Hwy
Independence, MO 64055-5929
Phone: (816) 897-5850
Fax: (816) 897-5851
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X

Record details

NPI number1245842202
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Lee — Partner · (816) 897-5850
NPI enumeratedAugust 20, 2020
Last updated in NPPESSeptember 14, 2020
Certification dateSeptember 1, 2020
Mailing address12400 E 40 Hwy, Independence, MO 64055-5929

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